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General NPI Number Information
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NPI Number | 1881744639
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Entity Type | Individual
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Provider Name | NICOLE ANN HOLONICH LCSW
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Gender | Female
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Dates
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Enumeration Date | 01/12/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 110 S ARCH ST SUITE 2A
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City | CONNELLSVILLE
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State | PA
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Zip | 15425-3515
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Country | US
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Telephone | 724-626-9941
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Fax | 724-626-2785
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Provider Business Mailing Address
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Address Line | 145 OGLEVEE LN
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City | CONNELLSVILLE
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State | PA
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Zip | 15425-3841
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Country | US
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Telephone | 724-626-9941
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Fax | 724-626-2785
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | CW015395
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License Number State | PA
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