Provider Demographics
NPI:1225004666
Name:HOLLAND, JOAN ARLINE (MED, LMHC)
Entity Type:Individual
Prefix:MS
First Name:JOAN
Middle Name:ARLINE
Last Name:HOLLAND
Suffix:
Gender:F
Credentials:MED, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 916
Mailing Address - Street 2:
Mailing Address - City:FERNANDINA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32035-0916
Mailing Address - Country:US
Mailing Address - Phone:904-753-1586
Mailing Address - Fax:904-491-0477
Practice Address - Street 1:501 CENTRE ST
Practice Address - Street 2:SUITE 117
Practice Address - City:FERNANDINA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32034-3936
Practice Address - Country:US
Practice Address - Phone:904-753-1563
Practice Address - Fax:904-491-0478
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-26
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH4487101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health