Provider Demographics
NPI:1265706758
Name:MEYER, HOLLY J (MFT)
Entity type:Individual
Prefix:
First Name:HOLLY
Middle Name:J
Last Name:MEYER
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 26630
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93729-6630
Mailing Address - Country:US
Mailing Address - Phone:559-324-0150
Mailing Address - Fax:559-298-0139
Practice Address - Street 1:49370 ROAD 426
Practice Address - Street 2:STE B
Practice Address - City:OAKHURST
Practice Address - State:CA
Practice Address - Zip Code:93644-9051
Practice Address - Country:US
Practice Address - Phone:559-324-0150
Practice Address - Fax:559-298-0139
Is Sole Proprietor?:No
Enumeration Date:2012-02-29
Last Update Date:2012-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAIMF67115101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health