Provider Demographics
NPI:1912205048
Name:HUTH, HOLLY ANN
Entity Type:Individual
Prefix:MISS
First Name:HOLLY
Middle Name:ANN
Last Name:HUTH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6227 WOODBURY AVE
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89103-3237
Mailing Address - Country:US
Mailing Address - Phone:727-278-7028
Mailing Address - Fax:
Practice Address - Street 1:730 N EASTERN AVE
Practice Address - Street 2:SUITE 110
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89101-2883
Practice Address - Country:US
Practice Address - Phone:702-772-4864
Practice Address - Fax:866-442-8199
Is Sole Proprietor?:No
Enumeration Date:2011-03-14
Last Update Date:2011-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health