Provider Demographics
NPI:1265568885
Name:ASHER DRINEN, HOLLY (PHD)
Entity type:Individual
Prefix:DR
First Name:HOLLY
Middle Name:
Last Name:ASHER DRINEN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:HOLLY
Other - Middle Name:
Other - Last Name:ASHER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD
Mailing Address - Street 1:4618 E ACOMA DR
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85032-4892
Mailing Address - Country:US
Mailing Address - Phone:602-996-6163
Mailing Address - Fax:
Practice Address - Street 1:11808 N 64TH ST
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85254-5010
Practice Address - Country:US
Practice Address - Phone:480-484-3204
Practice Address - Fax:480-484-3201
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-26
Last Update Date:2007-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ717928Medicare ID - Type UnspecifiedAHCCCS