Provider Demographics
NPI:1972234300
Name:SAUCEDO, HOLLYANN MARIE (LPCC)
Entity type:Individual
Prefix:MRS
First Name:HOLLYANN
Middle Name:MARIE
Last Name:SAUCEDO
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:MS
Other - First Name:HOLLYANN
Other - Middle Name:MARIE
Other - Last Name:NIEMIEC
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1923 MILLER ST APT 374A
Mailing Address - Street 2:
Mailing Address - City:LA CROSSE
Mailing Address - State:WI
Mailing Address - Zip Code:54601-8511
Mailing Address - Country:US
Mailing Address - Phone:630-487-0764
Mailing Address - Fax:
Practice Address - Street 1:111 E RIVERFRONT STREET
Practice Address - Street 2:SUITE 103
Practice Address - City:WINONA
Practice Address - State:MN
Practice Address - Zip Code:55987
Practice Address - Country:US
Practice Address - Phone:651-313-8080
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-17
Last Update Date:2022-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WILPCC101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health