Provider Demographics
NPI:1588674287
Name:HOLIAN, DOROTHY (PSYD)
Entity Type:Individual
Prefix:MS
First Name:DOROTHY
Middle Name:
Last Name:HOLIAN
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 S FRONT AVE
Mailing Address - Street 2:
Mailing Address - City:PRESTONSBURG
Mailing Address - State:KY
Mailing Address - Zip Code:41653-1614
Mailing Address - Country:US
Mailing Address - Phone:606-886-8572
Mailing Address - Fax:606-886-4433
Practice Address - Street 1:118 RIVER DR
Practice Address - Street 2:
Practice Address - City:PIKEVILLE
Practice Address - State:KY
Practice Address - Zip Code:41501-1597
Practice Address - Country:US
Practice Address - Phone:606-432-3143
Practice Address - Fax:606-437-5412
Is Sole Proprietor?:No
Enumeration Date:2006-08-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1209103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY1182791OtherCHA HEALTH
KY000000231102OtherANTHEM BC/BS
KY0675508Medicare ID - Type Unspecified
KY1182791OtherCHA HEALTH
KY0675708Medicare ID - Type Unspecified
KY0675608Medicare ID - Type Unspecified
KY000000231102OtherANTHEM BC/BS
KYP01839Medicare UPIN
KY0662411Medicare ID - Type Unspecified
KY0653309Medicare ID - Type Unspecified
KY1675408Medicare ID - Type Unspecified
KY0366415Medicare ID - Type Unspecified