Provider Demographics
NPI:1861655458
Name:HOLODAY, JEAN ANN (MA, LLPC, NCC)
Entity Type:Individual
Prefix:MRS
First Name:JEAN
Middle Name:ANN
Last Name:HOLODAY
Suffix:
Gender:F
Credentials:MA, LLPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4725 BRUNER DR
Mailing Address - Street 2:
Mailing Address - City:STERLING HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48310-2602
Mailing Address - Country:US
Mailing Address - Phone:258-926-4856
Mailing Address - Fax:
Practice Address - Street 1:4725 BRUNER DR
Practice Address - Street 2:
Practice Address - City:STERLING HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48310-2602
Practice Address - Country:US
Practice Address - Phone:258-926-4856
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-03
Last Update Date:2008-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401010532101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor