Provider Demographics
NPI:1457978819
Name:ALTSON, HOLLY D (PSYD)
Entity Type:Individual
Prefix:DR
First Name:HOLLY
Middle Name:D
Last Name:ALTSON
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1120 FINNEGAN WAY APT 6
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225-6640
Mailing Address - Country:US
Mailing Address - Phone:503-998-5234
Mailing Address - Fax:888-920-1837
Practice Address - Street 1:1120 FINNEGAN WAY APT 6
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-6640
Practice Address - Country:US
Practice Address - Phone:503-998-5234
Practice Address - Fax:888-920-1837
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-01
Last Update Date:2022-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR23195101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health