Provider Demographics
NPI:1407022056
Name:HOLTZ, ALICIA JOY (LMSW)
Entity Type:Individual
Prefix:MRS
First Name:ALICIA
Middle Name:JOY
Last Name:HOLTZ
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2010 HOGBACK RD
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48105-9749
Mailing Address - Country:US
Mailing Address - Phone:734-677-0918
Mailing Address - Fax:734-677-0964
Practice Address - Street 1:2010 HOGBACK RD
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48105-9749
Practice Address - Country:US
Practice Address - Phone:734-677-0918
Practice Address - Fax:734-677-0964
Is Sole Proprietor?:No
Enumeration Date:2008-05-05
Last Update Date:2008-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010844941041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical