Provider Demographics
NPI:1083768147
Name:HOLLANDER, LOREN E (PHD)
Entity Type:Individual
Prefix:DR
First Name:LOREN
Middle Name:E
Last Name:HOLLANDER
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14630 TALBOT ST
Mailing Address - Street 2:
Mailing Address - City:OAK PARK
Mailing Address - State:MI
Mailing Address - Zip Code:48237-1159
Mailing Address - Country:US
Mailing Address - Phone:248-763-8547
Mailing Address - Fax:248-435-4765
Practice Address - Street 1:30301 WOODWARD AVE
Practice Address - Street 2:SUITE LL165
Practice Address - City:ROYAL OAK
Practice Address - State:MI
Practice Address - Zip Code:48073-0979
Practice Address - Country:US
Practice Address - Phone:248-763-8547
Practice Address - Fax:248-435-4765
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301002855103T00000X, 103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103T00000XBehavioral Health & Social Service ProvidersPsychologist
Not Answered103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent