Provider Demographics
NPI:1427927755
Name:HOLLABAUGH, VERONICA (PMHNP-BC)
Entity type:Individual
Prefix:
First Name:VERONICA
Middle Name:
Last Name:HOLLABAUGH
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:445 GLEN PARK DR
Mailing Address - Street 2:
Mailing Address - City:BAY VILLAGE
Mailing Address - State:OH
Mailing Address - Zip Code:44140-2422
Mailing Address - Country:US
Mailing Address - Phone:818-390-1826
Mailing Address - Fax:
Practice Address - Street 1:445 GLEN PARK DR
Practice Address - Street 2:
Practice Address - City:BAY VILLAGE
Practice Address - State:OH
Practice Address - Zip Code:44140-2422
Practice Address - Country:US
Practice Address - Phone:818-390-1826
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-11-04
Last Update Date:2025-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH507301363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty