Provider Demographics
NPI:1750069969
Name:HOLSINGER, MARA LAUREN
Entity type:Individual
Prefix:
First Name:MARA
Middle Name:LAUREN
Last Name:HOLSINGER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2847 EARLYSTOWN RD
Mailing Address - Street 2:
Mailing Address - City:CENTRE HALL
Mailing Address - State:PA
Mailing Address - Zip Code:16828-9108
Mailing Address - Country:US
Mailing Address - Phone:814-574-0047
Mailing Address - Fax:
Practice Address - Street 1:2847 EARLYSTOWN RD
Practice Address - Street 2:
Practice Address - City:CENTRE HALL
Practice Address - State:PA
Practice Address - Zip Code:16828-9108
Practice Address - Country:US
Practice Address - Phone:814-574-0047
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-07
Last Update Date:2023-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW139883104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker