Provider Demographics
NPI:1790919025
Name:HOLLAND, PAUL ALLEN
Entity Type:Individual
Prefix:MR
First Name:PAUL
Middle Name:ALLEN
Last Name:HOLLAND
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9700 RESEARCH DR
Mailing Address - Street 2:SUITE 143
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28262-8552
Mailing Address - Country:US
Mailing Address - Phone:704-405-8095
Mailing Address - Fax:
Practice Address - Street 1:9700 RESEARCH DR
Practice Address - Street 2:SUITE 143
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28262-8552
Practice Address - Country:US
Practice Address - Phone:704-405-8095
Practice Address - Fax:704-405-8096
Is Sole Proprietor?:No
Enumeration Date:2009-05-14
Last Update Date:2009-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TH0100XBehavioral Health & Social Service ProvidersPsychologistHealth Service