Provider Demographics
NPI:1487432027
Name:THURBER, HOLLY (BS, MA, SAC-IT)
Entity type:Individual
Prefix:
First Name:HOLLY
Middle Name:
Last Name:THURBER
Suffix:
Gender:F
Credentials:BS, MA, SAC-IT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1849 N MLK DR
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53212-3639
Mailing Address - Country:US
Mailing Address - Phone:414-347-1774
Mailing Address - Fax:
Practice Address - Street 1:1849 N MLK DR
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53212-3639
Practice Address - Country:US
Practice Address - Phone:414-347-1774
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-15
Last Update Date:2023-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor