Provider Demographics
NPI:1720513179
Name:HOLLAND, KRISTINE (LGPC)
Entity Type:Individual
Prefix:
First Name:KRISTINE
Middle Name:
Last Name:HOLLAND
Suffix:
Gender:F
Credentials:LGPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:806 RICHMOND AVE
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20910-4914
Mailing Address - Country:US
Mailing Address - Phone:202-374-8527
Mailing Address - Fax:
Practice Address - Street 1:806 RICHMOND AVE
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20910-4914
Practice Address - Country:US
Practice Address - Phone:202-374-8527
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-24
Last Update Date:2017-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLGP7185101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional