Provider Demographics
NPI:1083021729
Name:HOLDREN, JULIA (MSED)
Entity Type:Individual
Prefix:
First Name:JULIA
Middle Name:
Last Name:HOLDREN
Suffix:
Gender:F
Credentials:MSED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2104 WINDSOR RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:WESTBOROUGH
Mailing Address - State:MA
Mailing Address - Zip Code:01581-2344
Mailing Address - Country:US
Mailing Address - Phone:570-768-0540
Mailing Address - Fax:
Practice Address - Street 1:2104 WINDSOR RIDGE DR
Practice Address - Street 2:
Practice Address - City:WESTBOROUGH
Practice Address - State:MA
Practice Address - Zip Code:01581-2344
Practice Address - Country:US
Practice Address - Phone:570-768-0540
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-15
Last Update Date:2014-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool