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General NPI Number Information
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NPI Number | 1477823854
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Entity Type | Individual
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Provider Name | HOLLY ELIZABETH WILKEY LMFT
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Gender | Female
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Dates
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Enumeration Date | 01/03/2012
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Last Update Date | 01/03/2012
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Provider Practice Location Address
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Address Line | 6540 LUSK BLVD SUITE C159
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City | SAN DIEGO
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State | CA
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Zip | 92121-2767
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Country | US
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Telephone | 760-415-0122
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Fax | 760-454-0444
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Provider Business Mailing Address
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Address Line | 16008 VIA DICHA
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City | RANCHO SANTA FE
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State | CA
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Zip | 92091-4252
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Country | US
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Telephone | 760-415-0122
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Fax | 760-454-0444
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | MFC48456
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License Number State | CA
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