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General NPI Number Information
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NPI Number | 1477055531
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Entity Type | Individual
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Provider Name | HOLLY ELIZABETH ZACHRY LPC
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Gender | Female
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Dates
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Enumeration Date | 03/05/2018
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Last Update Date | 04/21/2022
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Provider Practice Location Address
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Address Line | 1300 N 12TH ST STE 550
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City | PHOENIX
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State | AZ
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Zip | 85006-2820
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Country | US
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Telephone | 602-419-1463
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Fax |
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Provider Business Mailing Address
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Address Line | 109 S RIATA DR
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City | GILBERT
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State | AZ
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Zip | 85296-1147
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Country | US
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Telephone | 480-206-9098
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 15824
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License Number State | AZ
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