Wallace, Holly
Wallace, Holly is an individual health care provider with primary practice located at 1968 Sebring Pkwy , Sebring FL 33870-1654. She recently has only one registered license in Behavioral Health & Social Service Providers / Mental Health, which is considered as her primary health care specialty. Wallace, Holly can be contacted via phone (863) 519-0575.Contact Information
Primary practice address
1968 Sebring Pkwy
Sebring FL 33870-1654
Phone: (863) 519-0575
Fax: (863) 582-9251
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Mental Health | 101YM0800X | MH9182 | Florida |
Profile Details
| NPI number | 1699948844 |
|---|---|
| LBN Legal business name | Wallace, Holly |
| Credentials | LMHC |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 9th, 2008 |
| Last updated | Oct 29th, 2015 - about 9 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1699948844 | NPPES |
| Florida | MEDICAID | 002054100 |
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