Provider Demographics
NPI:1336481845
Name:HOLLAND, MICHELLE W (MA, CACI)
Entity Type:Individual
Prefix:MRS
First Name:MICHELLE
Middle Name:W
Last Name:HOLLAND
Suffix:
Gender:F
Credentials:MA, CACI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:441 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SUMTER
Mailing Address - State:SC
Mailing Address - Zip Code:29150-4232
Mailing Address - Country:US
Mailing Address - Phone:803-775-5080
Mailing Address - Fax:803-773-6256
Practice Address - Street 1:441 N MAIN ST
Practice Address - Street 2:
Practice Address - City:SUMTER
Practice Address - State:SC
Practice Address - Zip Code:29150-4232
Practice Address - Country:US
Practice Address - Phone:803-775-5080
Practice Address - Fax:803-773-6256
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-22
Last Update Date:2013-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)