Provider Demographics
NPI:1073664553
Name:HOLDEN, JANICE M (EDD)
Entity Type:Individual
Prefix:DR
First Name:JANICE
Middle Name:M
Last Name:HOLDEN
Suffix:
Gender:F
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1004 VISTA CT
Mailing Address - Street 2:
Mailing Address - City:LEWISVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75067-7490
Mailing Address - Country:US
Mailing Address - Phone:972-315-0300
Mailing Address - Fax:972-315-0308
Practice Address - Street 1:1004 VISTA CT
Practice Address - Street 2:
Practice Address - City:LEWISVILLE
Practice Address - State:TX
Practice Address - Zip Code:75067-7490
Practice Address - Country:US
Practice Address - Phone:972-315-0300
Practice Address - Fax:972-315-0308
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX9534101YP2500X
TX126106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist