Provider Demographics
NPI:1306122486
Name:SHIELD, HOLLY LORRAINE (MA/PLHP)
Entity type:Individual
Prefix:MRS
First Name:HOLLY
Middle Name:LORRAINE
Last Name:SHIELD
Suffix:
Gender:F
Credentials:MA/PLHP
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 779
Mailing Address - Street 2:
Mailing Address - City:RUSHVILLE
Mailing Address - State:NE
Mailing Address - Zip Code:69360-0779
Mailing Address - Country:US
Mailing Address - Phone:308-327-2026
Mailing Address - Fax:308-327-2126
Practice Address - Street 1:309 WEST 3RD STREET
Practice Address - Street 2:
Practice Address - City:RUSHVILLE
Practice Address - State:NE
Practice Address - Zip Code:69360
Practice Address - Country:US
Practice Address - Phone:308-327-2026
Practice Address - Fax:308-327-2126
Is Sole Proprietor?:No
Enumeration Date:2011-11-02
Last Update Date:2011-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE9479101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health