Provider Demographics
NPI:1972389385
Name:VORE, HOLLY (QMHP1)
Entity Type:Individual
Prefix:
First Name:HOLLY
Middle Name:
Last Name:VORE
Suffix:
Gender:F
Credentials:QMHP1
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 S J ST
Mailing Address - Street 2:
Mailing Address - City:LAKEVIEW
Mailing Address - State:OR
Mailing Address - Zip Code:97630-1623
Mailing Address - Country:US
Mailing Address - Phone:541-947-2114
Mailing Address - Fax:
Practice Address - Street 1:87520 BAY RD
Practice Address - Street 2:
Practice Address - City:CHRISTMAS VALLEY
Practice Address - State:OR
Practice Address - Zip Code:97641-2233
Practice Address - Country:US
Practice Address - Phone:541-947-2114
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-01
Last Update Date:2023-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health