Provider Demographics
NPI:1932731288
Name:HARDEN, HOLLY JOY (LMFTA)
Entity Type:Individual
Prefix:MRS
First Name:HOLLY
Middle Name:JOY
Last Name:HARDEN
Suffix:
Gender:F
Credentials:LMFTA
Other - Prefix:MISS
Other - First Name:HOLLY
Other - Middle Name:JOY
Other - Last Name:ALEXANDER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4613 124TH AVENUE CT E
Mailing Address - Street 2:
Mailing Address - City:EDGEWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98372-9278
Mailing Address - Country:US
Mailing Address - Phone:253-279-6971
Mailing Address - Fax:
Practice Address - Street 1:10005 24TH ST E
Practice Address - Street 2:
Practice Address - City:EDGEWOOD
Practice Address - State:WA
Practice Address - Zip Code:98371-2130
Practice Address - Country:US
Practice Address - Phone:253-259-3057
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-05
Last Update Date:2020-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMG61017480106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist