Provider Demographics
NPI:1619610474
Name:HOLOMAN, LINDA MOORE (LPC, EDD)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:MOORE
Last Name:HOLOMAN
Suffix:
Gender:F
Credentials:LPC, EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5812 INVERNESS CIR
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48642-7023
Mailing Address - Country:US
Mailing Address - Phone:989-600-2720
Mailing Address - Fax:989-631-7679
Practice Address - Street 1:5812 INVERNESS CIR
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:MI
Practice Address - Zip Code:48642-7023
Practice Address - Country:US
Practice Address - Phone:989-600-2720
Practice Address - Fax:989-631-7679
Is Sole Proprietor?:No
Enumeration Date:2022-04-19
Last Update Date:2022-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401003334101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional