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Jessica Elizabeth Holly, LICSW

Social Worker, Clinical in Minneapolis, MN. Individual provider (NPI-1).

NPI number1457636615
StatusActive
Last updated in NPPESDec 3, 2014

Details

NPI
1457636615
Entity type
Individual (NPI-1)
Name
Jessica Elizabeth Holly
Credential
LICSW
Sex
Female
Sole proprietor
No
Enumeration date
Oct 19, 2011
Last updated
Dec 3, 2014

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
1041C0700X Social Worker, Clinical19721MNYes

Practice location

1100 Glenwood Ave
Minneapolis, MN 55405-1430

Phone 612-871-1454 · Fax 612-871-1505

Mailing address

1100 Glenwood Ave
Minneapolis, MN 55405-1430

Phone 612-871-1454 · Fax 612-871-1505

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