Provider Demographics
NPI:1093066862
Name:HOLDEN, MAUREEN (CMT)
Entity Type:Individual
Prefix:MRS
First Name:MAUREEN
Middle Name:
Last Name:HOLDEN
Suffix:
Gender:F
Credentials:CMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1524 RED TAIL DR
Mailing Address - Street 2:
Mailing Address - City:ROCK SPRINGS
Mailing Address - State:WY
Mailing Address - Zip Code:82901-5882
Mailing Address - Country:US
Mailing Address - Phone:307-362-2610
Mailing Address - Fax:
Practice Address - Street 1:2908 FOOTHILL BLVD STE B
Practice Address - Street 2:
Practice Address - City:ROCK SPRINGS
Practice Address - State:WY
Practice Address - Zip Code:82901-4956
Practice Address - Country:US
Practice Address - Phone:307-362-5338
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-19
Last Update Date:2012-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist