Provider Demographics
NPI:1912706920
Name:HOLLIMAN, DIANE CAROL (PHD, LCSW)
Entity type:Individual
Prefix:DR
First Name:DIANE
Middle Name:CAROL
Last Name:HOLLIMAN
Suffix:
Gender:
Credentials:PHD, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:73 CANDLEGLOW TRL
Mailing Address - Street 2:
Mailing Address - City:VALDOSTA
Mailing Address - State:GA
Mailing Address - Zip Code:31602-8047
Mailing Address - Country:US
Mailing Address - Phone:229-560-8645
Mailing Address - Fax:
Practice Address - Street 1:73 CANDLEGLOW TRL
Practice Address - Street 2:
Practice Address - City:VALDOSTA
Practice Address - State:GA
Practice Address - Zip Code:31602-8047
Practice Address - Country:US
Practice Address - Phone:229-560-8645
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-11
Last Update Date:2025-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty