Provider Demographics
NPI:1841854544
Name:HOLLIHAN LEAVITT, HILARY VIOLET (MED)
Entity type:Individual
Prefix:MRS
First Name:HILARY
Middle Name:VIOLET
Last Name:HOLLIHAN LEAVITT
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2030 WYOMING DR
Mailing Address - Street 2:
Mailing Address - City:GREEN RIVER
Mailing Address - State:WY
Mailing Address - Zip Code:82935-5851
Mailing Address - Country:US
Mailing Address - Phone:307-871-1534
Mailing Address - Fax:
Practice Address - Street 1:2030 WYOMING DR
Practice Address - Street 2:
Practice Address - City:GREEN RIVER
Practice Address - State:WY
Practice Address - Zip Code:82935-5851
Practice Address - Country:US
Practice Address - Phone:307-871-1534
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-28
Last Update Date:2019-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator