Provider Demographics
NPI:1669290839
Name:WAMSHER, HOLLY (PSYD, BSL)
Entity type:Individual
Prefix:
First Name:HOLLY
Middle Name:
Last Name:WAMSHER
Suffix:
Gender:F
Credentials:PSYD, BSL
Other - Prefix:
Other - First Name:HOLLY
Other - Middle Name:
Other - Last Name:WAGNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BSL
Mailing Address - Street 1:19 VALLEY VIEW RD
Mailing Address - Street 2:
Mailing Address - City:BIRDSBORO
Mailing Address - State:PA
Mailing Address - Zip Code:19508-1522
Mailing Address - Country:US
Mailing Address - Phone:484-219-6289
Mailing Address - Fax:
Practice Address - Street 1:925 BERKSHIRE BLVD
Practice Address - Street 2:
Practice Address - City:WYOMISSING
Practice Address - State:PA
Practice Address - Zip Code:19610-1229
Practice Address - Country:US
Practice Address - Phone:484-516-2330
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-27
Last Update Date:2024-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS020287103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical