Provider Demographics
NPI:1912663311
Name:KHUU, HOLLY (LBS)
Entity Type:Individual
Prefix:
First Name:HOLLY
Middle Name:
Last Name:KHUU
Suffix:
Gender:F
Credentials:LBS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:224 NAZARETH PIKE UNIT 22A
Mailing Address - Street 2:
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18020-9084
Mailing Address - Country:US
Mailing Address - Phone:610-365-8373
Mailing Address - Fax:
Practice Address - Street 1:224 NAZARETH PIKE UNIT 22A
Practice Address - Street 2:
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18020-9084
Practice Address - Country:US
Practice Address - Phone:484-542-4004
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-10
Last Update Date:2023-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PABH005635251S00000X
PABA005635103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst