Provider Demographics
NPI:1730420670
Name:HAZLETT-STEVENS, HOLLY (PHD)
Entity type:Individual
Prefix:
First Name:HOLLY
Middle Name:
Last Name:HAZLETT-STEVENS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5421 KIETZKE LN
Mailing Address - Street 2:SUITE 202
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89511-3027
Mailing Address - Country:US
Mailing Address - Phone:775-360-4660
Mailing Address - Fax:775-360-4660
Practice Address - Street 1:5421 KIETZKE LN
Practice Address - Street 2:SUITE 202
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89511-3027
Practice Address - Country:US
Practice Address - Phone:775-360-4660
Practice Address - Fax:775-360-4660
Is Sole Proprietor?:No
Enumeration Date:2013-03-01
Last Update Date:2013-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVPY0518103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical