Provider Demographics
NPI:1447364021
Name:STRATTON, HOLLY MAE (RSWA)
Entity type:Individual
Prefix:
First Name:HOLLY
Middle Name:MAE
Last Name:STRATTON
Suffix:
Gender:F
Credentials:RSWA
Other - Prefix:
Other - First Name:HOLLY
Other - Middle Name:MAE
Other - Last Name:HARTRUM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RSWA
Mailing Address - Street 1:PO BOX 765
Mailing Address - Street 2:
Mailing Address - City:BUCYRUS
Mailing Address - State:OH
Mailing Address - Zip Code:44820-0765
Mailing Address - Country:US
Mailing Address - Phone:419-562-2000
Mailing Address - Fax:419-562-1296
Practice Address - Street 1:2458 STETZER RD
Practice Address - Street 2:
Practice Address - City:BUCYRUS
Practice Address - State:OH
Practice Address - Zip Code:44820-2066
Practice Address - Country:US
Practice Address - Phone:419-562-2000
Practice Address - Fax:419-562-1296
Is Sole Proprietor?:No
Enumeration Date:2006-08-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHW0500253101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health