Provider Demographics
NPI:1174687941
Name:HOLMAN, LARRY (LMFT)
Entity Type:Individual
Prefix:
First Name:LARRY
Middle Name:
Last Name:HOLMAN
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1407 W 31ST AVE
Mailing Address - Street 2:SUITE 602
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99503-3678
Mailing Address - Country:US
Mailing Address - Phone:907-272-7002
Mailing Address - Fax:907-272-9726
Practice Address - Street 1:1407 W 31ST AVE
Practice Address - Street 2:SUITE 602
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99503-3678
Practice Address - Country:US
Practice Address - Phone:907-272-7002
Practice Address - Fax:907-272-9726
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-19
Last Update Date:2014-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK26106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist