Provider Demographics
NPI:1033465521
Name:HOLLAND, JEMIRAH HELENA (MSW)
Entity Type:Individual
Prefix:
First Name:JEMIRAH
Middle Name:HELENA
Last Name:HOLLAND
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:JEMIRAH
Other - Middle Name:HELENA
Other - Last Name:JACKSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW
Mailing Address - Street 1:1950 MIDYETTE CT APT 1B
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32301-6215
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1834A JACLIF CT
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32308-4400
Practice Address - Country:US
Practice Address - Phone:850-681-6001
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-02
Last Update Date:2012-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health