Provider Demographics
NPI:1841951845
Name:HOLLY, DANIELLE ALTHEA (EDD)
Entity type:Individual
Prefix:DR
First Name:DANIELLE
Middle Name:ALTHEA
Last Name:HOLLY
Suffix:
Gender:F
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:507 WOLFE DR
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:NJ
Mailing Address - Zip Code:08518-4007
Mailing Address - Country:US
Mailing Address - Phone:973-449-3400
Mailing Address - Fax:
Practice Address - Street 1:507 WOLFE DR
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:NJ
Practice Address - Zip Code:08518-4007
Practice Address - Country:US
Practice Address - Phone:973-449-3400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-03
Last Update Date:2022-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103TS0200X
NJ103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool