Provider Demographics
NPI:1609036508
Name:BROWN-SISSON, HOLLY (LPC)
Entity Type:Individual
Prefix:
First Name:HOLLY
Middle Name:
Last Name:BROWN-SISSON
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5049 E BROADWAY BLVD
Mailing Address - Street 2:SUITE 108
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85711-3645
Mailing Address - Country:US
Mailing Address - Phone:520-748-2300
Mailing Address - Fax:520-748-2355
Practice Address - Street 1:5049 E BROADWAY BLVD
Practice Address - Street 2:SUITE 108
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85711-3645
Practice Address - Country:US
Practice Address - Phone:520-748-2300
Practice Address - Fax:520-748-2355
Is Sole Proprietor?:No
Enumeration Date:2008-06-13
Last Update Date:2008-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ13016101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional