Provider Demographics
NPI:1336425610
Name:HOLLAND, ANN TERESA (LPC-S, NCC)
Entity Type:Individual
Prefix:MRS
First Name:ANN
Middle Name:TERESA
Last Name:HOLLAND
Suffix:
Gender:F
Credentials:LPC-S, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3415 HILL VW
Mailing Address - Street 2:
Mailing Address - City:BOYNE FALLS
Mailing Address - State:MI
Mailing Address - Zip Code:49713-9668
Mailing Address - Country:US
Mailing Address - Phone:231-675-3150
Mailing Address - Fax:
Practice Address - Street 1:3415 HILL VW
Practice Address - Street 2:
Practice Address - City:BOYNE FALLS
Practice Address - State:MI
Practice Address - Zip Code:49713-9668
Practice Address - Country:US
Practice Address - Phone:231-675-3150
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-31
Last Update Date:2011-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI64010111197101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor