Provider Demographics
NPI:1730288689
Name:HOLLIDAY, STEPHEN LEE (PHD)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:LEE
Last Name:HOLLIDAY
Suffix:
Gender:M
Credentials:PHD
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Mailing Address - Street 1:7400 MERTON MINTER BLVD.
Mailing Address - Street 2:PSYCHOLOGY SERVICE (116B)
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-4404
Mailing Address - Country:US
Mailing Address - Phone:210-617-5121
Mailing Address - Fax:210-949-3301
Practice Address - Street 1:7400 MERTON MINTER BLVD.
Practice Address - Street 2:PSYCHOLOGY SERVICE (116B)
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-4404
Practice Address - Country:US
Practice Address - Phone:210-617-5121
Practice Address - Fax:210-949-3301
Is Sole Proprietor?:No
Enumeration Date:2006-09-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX3206103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist