MEDICARE: JILL B. HOILIEN LPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	417	OK

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	417	OTHER	OK	STATE DEPARTMENT OF HEALTH / LICENSED PROFESSIONAL COUNSELOR

General Provider Information

NPI Number	:	1093944159
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JILL B. HOILIEN LPC

Provider Business Mailing Address
First Line	:	PO BOX 52002
Second Line	:
City	:	TULSA
State	:	OK
Zip	:	74152-0002
Country	:	US
Telephone Number	:	918-747-3316
Fax Number	:

Provider Business Practice Location Address
First Line	:	3401 S YORKTOWN AVE
Second Line	:
City	:	TULSA
State	:	OK
Zip	:	74105-2723
Country	:	US
Telephone Number	:	918-747-3316
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/10/2009
Last Update Date	:	07/10/2009

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