Champa, Holly Ann

Champa, Holly Ann is an individual health care provider with primary practice located at 1970 Michigan Ave J 2, Cocoa FL 32922-5758. She recently has only one registered license in Behavioral Health & Social Service Providers / Mental Health, which is considered as her primary health care specialty. Champa, Holly Ann can be contacted via phone (321) 639-4483.

Contact Information

Primary practice address
1970 Michigan Ave J 2 Cocoa FL 32922-5758
Fax: (321) 690-0848
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X MH 6888 Florida

Profile Details

NPI number 1215990197
LBN Legal business name Champa, Holly Ann
Credentials LMHC
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 10th, 2006
Last updated Sep 9th, 2008 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1215990197 NPPES
Florida Other Z9402 BLUE CROSS BLUE SHIELD

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