Provider Demographics
NPI:1316209208
Name:RIENDEAU, HOLLY M (MSW)
Entity type:Individual
Prefix:MS
First Name:HOLLY
Middle Name:M
Last Name:RIENDEAU
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:HOLLY
Other - Middle Name:M
Other - Last Name:GALLAGHER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:906 MAIN AVE
Mailing Address - Street 2:
Mailing Address - City:TILLAMOOK
Mailing Address - State:OR
Mailing Address - Zip Code:97141-3816
Mailing Address - Country:US
Mailing Address - Phone:503-842-8201
Mailing Address - Fax:503-815-1870
Practice Address - Street 1:906 MAIN AVE
Practice Address - Street 2:
Practice Address - City:TILLAMOOK
Practice Address - State:OR
Practice Address - Zip Code:97141-3816
Practice Address - Country:US
Practice Address - Phone:503-842-8201
Practice Address - Fax:503-815-1870
Is Sole Proprietor?:No
Enumeration Date:2012-06-15
Last Update Date:2017-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical