Provider Demographics
NPI:1104093608
Name:VANHOLLEBEKE, ELAYNE NICOLE
Entity type:Individual
Prefix:
First Name:ELAYNE
Middle Name:NICOLE
Last Name:VANHOLLEBEKE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ELAYNE
Other - Middle Name:NICOLE
Other - Last Name:EPPS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4900 W 32ND AVE
Mailing Address - Street 2:
Mailing Address - City:KENNEWICK
Mailing Address - State:WA
Mailing Address - Zip Code:99338-2707
Mailing Address - Country:US
Mailing Address - Phone:509-840-4010
Mailing Address - Fax:
Practice Address - Street 1:2139 VAN GIESEN ST
Practice Address - Street 2:
Practice Address - City:RICHLAND
Practice Address - State:WA
Practice Address - Zip Code:99354-2746
Practice Address - Country:US
Practice Address - Phone:509-840-4010
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-13
Last Update Date:2012-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor