Provider Demographics
NPI:1548589401
Name:HOLLAND, ESTELLE
Entity Type:Individual
Prefix:
First Name:ESTELLE
Middle Name:
Last Name:HOLLAND
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 1:1105 LYNNWOOD ST
Mailing Address - Street 2:
Mailing Address - City:DURANT
Mailing Address - State:OK
Mailing Address - Zip Code:74701-2919
Mailing Address - Country:US
Mailing Address - Phone:580-931-3441
Mailing Address - Fax:580-931-3460
Practice Address - Street 1:1105 LYNNWOOD ST
Practice Address - Street 2:
Practice Address - City:DURANT
Practice Address - State:OK
Practice Address - Zip Code:74701-2919
Practice Address - Country:US
Practice Address - Phone:580-931-3441
Practice Address - Fax:580-931-3460
Is Sole Proprietor?:No
Enumeration Date:2010-05-18
Last Update Date:2010-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor