Provider Demographics
NPI:1942871298
Name:HOLLEBIER, VALA (CM)
Entity Type:Individual
Prefix:
First Name:VALA
Middle Name:
Last Name:HOLLEBIER
Suffix:
Gender:F
Credentials:CM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:827 FAIRMONT RD
Mailing Address - Street 2:
Mailing Address - City:WESTOVER
Mailing Address - State:WV
Mailing Address - Zip Code:26501-0087
Mailing Address - Country:US
Mailing Address - Phone:306-292-1716
Mailing Address - Fax:
Practice Address - Street 1:827 FAIRMONT RD
Practice Address - Street 2:
Practice Address - City:WESTOVER
Practice Address - State:WV
Practice Address - Zip Code:26501-0087
Practice Address - Country:US
Practice Address - Phone:306-292-1716
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-08
Last Update Date:2021-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty