Provider Demographics
NPI:1659697399
Name:SCANES, HOLLY R (PHD)
Entity Type:Individual
Prefix:
First Name:HOLLY
Middle Name:R
Last Name:SCANES
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3926 JFK PKWY
Mailing Address - Street 2:9B
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80525-3083
Mailing Address - Country:US
Mailing Address - Phone:970-282-8282
Mailing Address - Fax:303-200-7098
Practice Address - Street 1:3926 JFK PKWY
Practice Address - Street 2:9B
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80525-3083
Practice Address - Country:US
Practice Address - Phone:970-744-9292
Practice Address - Fax:970-282-3435
Is Sole Proprietor?:No
Enumeration Date:2010-04-19
Last Update Date:2014-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO48G2281123A103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling