Provider Demographics
NPI:1538738539
Name:DAVISBORRERO, HOLLY (LMFT, LMHC)
Entity type:Individual
Prefix:
First Name:HOLLY
Middle Name:
Last Name:DAVISBORRERO
Suffix:
Gender:F
Credentials:LMFT, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:685 SPRING ST # 228
Mailing Address - Street 2:
Mailing Address - City:FRIDAY HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98250-8058
Mailing Address - Country:US
Mailing Address - Phone:206-660-4444
Mailing Address - Fax:
Practice Address - Street 1:826 CAMINO DE MONTE REY STE A6
Practice Address - Street 2:
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87505-3961
Practice Address - Country:US
Practice Address - Phone:206-660-4444
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-23
Last Update Date:2021-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMCMH0202291103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling