| NPI | 1033960653 |
|---|---|
| Former Name | HOLLY NISSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: UT 90946573503) |
| Additional Taxonomies | 225800000X Recreation Therapist (Licence: UT 90946574001) |
| Enumeration Date | 2024-04-01 |
| Last Update Date | 2025-07-17 |