Provider Demographics
NPI:1518010552
Name:HOLMAN, SANDRA L (PHD)
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:L
Last Name:HOLMAN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1191 E ORCHARD RD
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD VILLAGE
Mailing Address - State:CO
Mailing Address - Zip Code:80121-1348
Mailing Address - Country:US
Mailing Address - Phone:303-795-1800
Mailing Address - Fax:303-795-1800
Practice Address - Street 1:6059 S QUEBEC ST
Practice Address - Street 2:#203
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80111-4514
Practice Address - Country:US
Practice Address - Phone:303-220-9720
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO9780051041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO96146Medicare ID - Type Unspecified