Provider Demographics
NPI:1821464454
Name:STEINBERG, HOLLY (LMBT)
Entity Type:Individual
Prefix:
First Name:HOLLY
Middle Name:
Last Name:STEINBERG
Suffix:
Gender:F
Credentials:LMBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2200 RANDOLPH RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28207-1126
Mailing Address - Country:US
Mailing Address - Phone:704-965-9156
Mailing Address - Fax:
Practice Address - Street 1:2200 RANDOLPH RD
Practice Address - Street 2:SUITE A
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28207-1126
Practice Address - Country:US
Practice Address - Phone:704-965-9156
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-18
Last Update Date:2015-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9423171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor