Provider Demographics
NPI:1902037856
Name:HOLLOMON, MICHELLE (LMHC)
Entity Type:Individual
Prefix:MRS
First Name:MICHELLE
Middle Name:
Last Name:HOLLOMON
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8201 164TH AVE NE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:REDMOND
Mailing Address - State:WA
Mailing Address - Zip Code:98052-7604
Mailing Address - Country:US
Mailing Address - Phone:425-999-9470
Mailing Address - Fax:425-242-0541
Practice Address - Street 1:8201 164TH AVE NE
Practice Address - Street 2:SUITE 200
Practice Address - City:REDMOND
Practice Address - State:WA
Practice Address - Zip Code:98052-7604
Practice Address - Country:US
Practice Address - Phone:425-999-9470
Practice Address - Fax:425-242-0541
Is Sole Proprietor?:No
Enumeration Date:2009-07-27
Last Update Date:2009-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH 60077037101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health