Provider Demographics
NPI:1407525710
Name:HOLDEN, RENEE
Entity Type:Individual
Prefix:
First Name:RENEE
Middle Name:
Last Name:HOLDEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3020 ORANGEMAN SQUARE
Mailing Address - Street 2:APTG
Mailing Address - City:WALDORF
Mailing Address - State:MD
Mailing Address - Zip Code:20602-1933
Mailing Address - Country:US
Mailing Address - Phone:301-728-2824
Mailing Address - Fax:
Practice Address - Street 1:ISABELLA JENKINS
Practice Address - Street 2:206 WAYNE PLACE SE APTG2
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20032
Practice Address - Country:US
Practice Address - Phone:202-574-0864
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-09
Last Update Date:2021-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TH0100XBehavioral Health & Social Service ProvidersPsychologistHealth Service