Provider Demographics
NPI:1043446677
Name:OVERHOLSER, DENISE RENEE
Entity type:Individual
Prefix:
First Name:DENISE
Middle Name:RENEE
Last Name:OVERHOLSER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 92
Mailing Address - Street 2:
Mailing Address - City:CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23832-0001
Mailing Address - Country:US
Mailing Address - Phone:804-717-6160
Mailing Address - Fax:804-768-9283
Practice Address - Street 1:6801 LUCY CORR CT
Practice Address - Street 2:
Practice Address - City:CHESTERFIELD
Practice Address - State:VA
Practice Address - Zip Code:23832-6657
Practice Address - Country:US
Practice Address - Phone:804-717-6160
Practice Address - Fax:804-768-9283
Is Sole Proprietor?:No
Enumeration Date:2009-06-10
Last Update Date:2016-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health