Provider Demographics
NPI:1407984016
Name:HOLGATE-WILLIAMS, STEPHANE LEIGH (SR PSY EXAMINER)
Entity Type:Individual
Prefix:MRS
First Name:STEPHANE
Middle Name:LEIGH
Last Name:HOLGATE-WILLIAMS
Suffix:
Gender:F
Credentials:SR PSY EXAMINER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2554 SOWELL MILL PIKE
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:TN
Mailing Address - Zip Code:38401-7446
Mailing Address - Country:US
Mailing Address - Phone:931-388-8045
Mailing Address - Fax:
Practice Address - Street 1:1222 MEDICAL CENTER DR
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:TN
Practice Address - Zip Code:38401-6402
Practice Address - Country:US
Practice Address - Phone:931-490-1500
Practice Address - Fax:931-490-1502
Is Sole Proprietor?:No
Enumeration Date:2007-03-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNPE0000011471101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor