Provider Demographics
NPI:1194590620
Name:HARNSBERGER, HOLLY ANN (NBC-HWC)
Entity type:Individual
Prefix:MS
First Name:HOLLY
Middle Name:ANN
Last Name:HARNSBERGER
Suffix:
Gender:F
Credentials:NBC-HWC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 335
Mailing Address - Street 2:
Mailing Address - City:SPRINGER
Mailing Address - State:OK
Mailing Address - Zip Code:73458-0335
Mailing Address - Country:US
Mailing Address - Phone:580-220-5950
Mailing Address - Fax:
Practice Address - Street 1:53 SNOWFIRE DR
Practice Address - Street 2:
Practice Address - City:SPRINGER
Practice Address - State:OK
Practice Address - Zip Code:73458-9500
Practice Address - Country:US
Practice Address - Phone:580-220-5950
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-15
Last Update Date:2023-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKA-3524818171400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach