Provider Demographics
NPI:1295440840
Name:GARMON, HOLLY MARIE (MA, LMHC)
Entity type:Individual
Prefix:
First Name:HOLLY
Middle Name:MARIE
Last Name:GARMON
Suffix:
Gender:F
Credentials:MA, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13311 SEASIDE HARBOUR DR
Mailing Address - Street 2:
Mailing Address - City:NORTH FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33903-7119
Mailing Address - Country:US
Mailing Address - Phone:205-504-9524
Mailing Address - Fax:
Practice Address - Street 1:13311 SEASIDE HARBOUR DR
Practice Address - Street 2:
Practice Address - City:NORTH FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33903-7119
Practice Address - Country:US
Practice Address - Phone:205-504-9524
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-18
Last Update Date:2023-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH14134101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health