Provider Demographics
NPI:1487974291
Name:HARTWIG MOORHEAD, HOLLY JOY (PHD)
Entity type:Individual
Prefix:DR
First Name:HOLLY
Middle Name:JOY
Last Name:HARTWIG MOORHEAD
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:HOLLY
Other - Middle Name:JOY
Other - Last Name:HARTWIG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:1112 VIEWMONT DR
Mailing Address - Street 2:
Mailing Address - City:ASHEBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27205-4149
Mailing Address - Country:US
Mailing Address - Phone:336-301-4127
Mailing Address - Fax:
Practice Address - Street 1:1112 VIEWMONT DR
Practice Address - Street 2:
Practice Address - City:ASHEBORO
Practice Address - State:NC
Practice Address - Zip Code:27205-4149
Practice Address - Country:US
Practice Address - Phone:336-301-4127
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-03
Last Update Date:2010-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4128101YP2500X
OHE4153101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional