Provider Demographics
NPI:1700108388
Name:HOLUBEC, SUZANNE (LBSW,IPR)
Entity Type:Individual
Prefix:MRS
First Name:SUZANNE
Middle Name:
Last Name:HOLUBEC
Suffix:
Gender:F
Credentials:LBSW,IPR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1024
Mailing Address - Street 2:
Mailing Address - City:MELVIN
Mailing Address - State:TX
Mailing Address - Zip Code:76858-0024
Mailing Address - Country:US
Mailing Address - Phone:325-286-4522
Mailing Address - Fax:325-286-4522
Practice Address - Street 1:704 N. BLACKBURN
Practice Address - Street 2:
Practice Address - City:BRADY
Practice Address - State:TX
Practice Address - Zip Code:76825-4001
Practice Address - Country:US
Practice Address - Phone:325-286-4522
Practice Address - Fax:325-286-4522
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-23
Last Update Date:2010-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX30553171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator