Provider Demographics
NPI:1558668194
Name:HARELAND, HOLLY
Entity type:Individual
Prefix:MISS
First Name:HOLLY
Middle Name:
Last Name:HARELAND
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2265 S. JONES BLVD SUITE D
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89165
Mailing Address - Country:US
Mailing Address - Phone:702-733-8098
Mailing Address - Fax:
Practice Address - Street 1:2265 S. JONES BLVD SUITE D
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89165
Practice Address - Country:US
Practice Address - Phone:702-733-8098
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-17
Last Update Date:2011-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker