Provider Demographics
NPI:1922217504
Name:MAREK, HOLLY MARGARET (RN, LMFT)
Entity Type:Individual
Prefix:
First Name:HOLLY
Middle Name:MARGARET
Last Name:MAREK
Suffix:
Gender:F
Credentials:RN, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 CANTLEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:SOMERS
Mailing Address - State:CT
Mailing Address - Zip Code:06071-1102
Mailing Address - Country:US
Mailing Address - Phone:860-749-5154
Mailing Address - Fax:860-749-5154
Practice Address - Street 1:21 HYDE PARK RD
Practice Address - Street 2:
Practice Address - City:STAFFORD SPRINGS
Practice Address - State:CT
Practice Address - Zip Code:06076-1507
Practice Address - Country:US
Practice Address - Phone:860-684-4239
Practice Address - Fax:860-684-0511
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001203106H00000X
CTR37245163WC3500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Not Answered163WC3500XNursing Service ProvidersRegistered NurseCardiac Rehabilitation