Provider Demographics
NPI:1679382717
Name:GRASSO, HOLLY
Entity type:Individual
Prefix:
First Name:HOLLY
Middle Name:
Last Name:GRASSO
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 1:3637 SAN PEDRO CT
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80906-4916
Mailing Address - Country:US
Mailing Address - Phone:497-562-8813
Mailing Address - Fax:
Practice Address - Street 1:1755 OLD RANCH RD
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80908
Practice Address - Country:US
Practice Address - Phone:719-425-8876
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-03
Last Update Date:2025-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health