Provider Demographics
NPI:1508988049
Name:HOLLAND, NANCY D (LPE)
Entity Type:Individual
Prefix:MRS
First Name:NANCY
Middle Name:D
Last Name:HOLLAND
Suffix:
Gender:F
Credentials:LPE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4211 GREEN SHANTY RD
Mailing Address - Street 2:
Mailing Address - City:OOLTEWAH
Mailing Address - State:TN
Mailing Address - Zip Code:37363-8443
Mailing Address - Country:US
Mailing Address - Phone:423-894-6598
Mailing Address - Fax:
Practice Address - Street 1:5805 LEE HWY
Practice Address - Street 2:SUITE 205
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37421-3546
Practice Address - Country:US
Practice Address - Phone:423-894-6588
Practice Address - Fax:423-894-2957
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNCPC1377101YP2500X
TNPE01456103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Not Answered103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool