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General NPI Number Information
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NPI Number | 1538738539
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Entity Type | Individual
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Provider Name | HOLLY DAVISBORRERO LMFT, LMHC
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Gender | Female
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Dates
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Enumeration Date | 06/23/2021
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Last Update Date | 06/23/2021
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Provider Practice Location Address
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Address Line | 826 CAMINO DE MONTE REY STE A6
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City | SANTA FE
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State | NM
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Zip | 87505-3961
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Country | US
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Telephone | 206-660-4444
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Fax |
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Provider Business Mailing Address
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Address Line | 685 SPRING ST # 228
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City | FRIDAY HARBOR
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State | WA
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Zip | 98250-8058
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Country | US
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Telephone | 206-660-4444
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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 | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number | CMH0202291
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License Number State | NM
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