Provider Demographics
NPI:1912418542
Name:ALLEN, HOLLY FRANCES (BS & MSPC)
Entity Type:Individual
Prefix:
First Name:HOLLY
Middle Name:FRANCES
Last Name:ALLEN
Suffix:
Gender:F
Credentials:BS & MSPC
Other - Prefix:
Other - First Name:HOLLY
Other - Middle Name:FRANCES
Other - Last Name:RULOFSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BS
Mailing Address - Street 1:2706 ANKENY WAY
Mailing Address - Street 2:
Mailing Address - City:ROCK SPRINGS
Mailing Address - State:WY
Mailing Address - Zip Code:82901-5649
Mailing Address - Country:US
Mailing Address - Phone:307-352-6677
Mailing Address - Fax:
Practice Address - Street 1:2706 ANKENY WAY
Practice Address - Street 2:
Practice Address - City:ROCK SPRINGS
Practice Address - State:WY
Practice Address - Zip Code:82901-5649
Practice Address - Country:US
Practice Address - Phone:307-352-6677
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-23
Last Update Date:2021-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WYPPC-1060101Y00000X
WYLPC1962101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor