Provider Demographics
NPI:1700057247
Name:ALEXANDER, HOLLY LOUISE (PCC)
Entity Type:Individual
Prefix:MS
First Name:HOLLY
Middle Name:LOUISE
Last Name:ALEXANDER
Suffix:
Gender:F
Credentials:PCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 SPINK ST
Mailing Address - Street 2:GAULT LIBERTY CENTER
Mailing Address - City:WOOSTER
Mailing Address - State:OH
Mailing Address - Zip Code:44691-3652
Mailing Address - Country:US
Mailing Address - Phone:330-263-6021
Mailing Address - Fax:330-262-6245
Practice Address - Street 1:104 SPINK ST
Practice Address - Street 2:GAULT LIBERTY CENTER
Practice Address - City:WOOSTER
Practice Address - State:OH
Practice Address - Zip Code:44691-3652
Practice Address - Country:US
Practice Address - Phone:330-263-6021
Practice Address - Fax:330-262-6245
Is Sole Proprietor?:No
Enumeration Date:2008-03-12
Last Update Date:2008-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE. 0004136101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional