Provider Demographics
NPI:1194280149
Name:VOLLINK-LENT, HOLLY KAY (MDIV, NCPSYA, LP)
Entity type:Individual
Prefix:MS
First Name:HOLLY
Middle Name:KAY
Last Name:VOLLINK-LENT
Suffix:
Gender:F
Credentials:MDIV, NCPSYA, LP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:95 ALLENS CREEK RD STE 327
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14618-3246
Mailing Address - Country:US
Mailing Address - Phone:585-410-1961
Mailing Address - Fax:
Practice Address - Street 1:95 ALLENS CREEK ROAD
Practice Address - Street 2:BLDG 2, STE 327
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14618
Practice Address - Country:US
Practice Address - Phone:585-410-1961
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-04
Last Update Date:2019-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000742-1102L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes102L00000XBehavioral Health & Social Service ProvidersPsychoanalyst