Provider Demographics
NPI:1912564600
Name:HOLAHAN, CLARE DONLEY
Entity Type:Individual
Prefix:
First Name:CLARE
Middle Name:DONLEY
Last Name:HOLAHAN
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 1:17 E GENESEE ST STE 1
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:NY
Mailing Address - Zip Code:13021-4068
Mailing Address - Country:US
Mailing Address - Phone:315-253-3255
Mailing Address - Fax:
Practice Address - Street 1:17 E GENESEE ST STE 1
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:NY
Practice Address - Zip Code:13021-4068
Practice Address - Country:US
Practice Address - Phone:315-253-3952
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-29
Last Update Date:2019-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health