Provider Demographics
NPI:1427420777
Name:LOCKHOFF, HOLLY (MS, RD, CSSS, LDN)
Entity type:Individual
Prefix:
First Name:HOLLY
Middle Name:
Last Name:LOCKHOFF
Suffix:
Gender:F
Credentials:MS, RD, CSSS, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4211 LANDIS RD
Mailing Address - Street 2:
Mailing Address - City:COLLEGEVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19426-1138
Mailing Address - Country:US
Mailing Address - Phone:610-937-2681
Mailing Address - Fax:
Practice Address - Street 1:165 MAIN ST STE 300
Practice Address - Street 2:
Practice Address - City:HARLEYSVILLE
Practice Address - State:PA
Practice Address - Zip Code:19438-2501
Practice Address - Country:US
Practice Address - Phone:484-854-3370
Practice Address - Fax:888-792-7497
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-27
Last Update Date:2024-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADN005423133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered