Provider Demographics
NPI:1366760696
Name:HOLLOMAN, RACHAEL SHINGLER (LPC)
Entity type:Individual
Prefix:MRS
First Name:RACHAEL
Middle Name:SHINGLER
Last Name:HOLLOMAN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1803 CANTERBURY DR STE C
Mailing Address - Street 2:
Mailing Address - City:VALDOSTA
Mailing Address - State:GA
Mailing Address - Zip Code:31602-0505
Mailing Address - Country:US
Mailing Address - Phone:229-247-4237
Mailing Address - Fax:229-247-4239
Practice Address - Street 1:1803 CANTERBURY DR STE C
Practice Address - Street 2:
Practice Address - City:VALDOSTA
Practice Address - State:GA
Practice Address - Zip Code:31602-0505
Practice Address - Country:US
Practice Address - Phone:229-247-4237
Practice Address - Fax:229-247-4239
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-11
Last Update Date:2010-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC005899101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health