Provider Demographics
NPI:1831300433
Name:HOLLANDER, MICHELE W (PSYD)
Entity Type:Individual
Prefix:DR
First Name:MICHELE
Middle Name:W
Last Name:HOLLANDER
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14911 DAMSON TER
Mailing Address - Street 2:
Mailing Address - City:NORTH POTOMAC
Mailing Address - State:MD
Mailing Address - Zip Code:20878-3338
Mailing Address - Country:US
Mailing Address - Phone:301-990-0131
Mailing Address - Fax:
Practice Address - Street 1:8929 SHADY GROVE CT
Practice Address - Street 2:
Practice Address - City:GAITHERSBURG
Practice Address - State:MD
Practice Address - Zip Code:20877-1308
Practice Address - Country:US
Practice Address - Phone:301-990-0131
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-24
Last Update Date:2009-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD03139103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD994501600Medicaid