Provider Demographics
NPI:1336719301
Name:YENCHA, HOLLY ANN (MA)
Entity Type:Individual
Prefix:
First Name:HOLLY
Middle Name:ANN
Last Name:YENCHA
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:HOLLY
Other - Middle Name:ANN
Other - Last Name:HOPE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4250 OLD WILLIAM PENN HWY
Mailing Address - Street 2:
Mailing Address - City:MONROEVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15146-1622
Mailing Address - Country:US
Mailing Address - Phone:412-573-0141
Mailing Address - Fax:
Practice Address - Street 1:4250 OLD WILLIAM PENN HWY
Practice Address - Street 2:
Practice Address - City:MONROEVILLE
Practice Address - State:PA
Practice Address - Zip Code:15146-1622
Practice Address - Country:US
Practice Address - Phone:412-573-0141
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-30
Last Update Date:2021-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PABH002887106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician