Provider Demographics
NPI:1508537168
Name:HOLLAND, TAMMY (LCMH)
Entity Type:Individual
Prefix:
First Name:TAMMY
Middle Name:
Last Name:HOLLAND
Suffix:
Gender:F
Credentials:LCMH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4231 TATTNALL RUN
Mailing Address - Street 2:
Mailing Address - City:ACWORTH
Mailing Address - State:GA
Mailing Address - Zip Code:30101-9559
Mailing Address - Country:US
Mailing Address - Phone:770-769-6264
Mailing Address - Fax:
Practice Address - Street 1:23000 SUSSEX HIGHWAY
Practice Address - Street 2:SUITE 163
Practice Address - City:SEAFORD
Practice Address - State:DE
Practice Address - Zip Code:19973-5866
Practice Address - Country:US
Practice Address - Phone:302-745-1157
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-23
Last Update Date:2024-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEPC-0011099101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health