Provider Demographics
NPI:1144501115
Name:HOLLENBECK, ALLEGRA (LMFT)
Entity type:Individual
Prefix:
First Name:ALLEGRA
Middle Name:
Last Name:HOLLENBECK
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19803 108TH AVE NE
Mailing Address - Street 2:
Mailing Address - City:BOTHELL
Mailing Address - State:WA
Mailing Address - Zip Code:98011-2414
Mailing Address - Country:US
Mailing Address - Phone:818-605-7719
Mailing Address - Fax:
Practice Address - Street 1:19803 108TH AVE NE
Practice Address - Street 2:
Practice Address - City:BOTHELL
Practice Address - State:WA
Practice Address - Zip Code:98011-2414
Practice Address - Country:US
Practice Address - Phone:818-605-7719
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-06
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALMFT86911106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist