Provider Demographics
NPI:1750589057
Name:HOLEWINSKI, DAVID THOMAS
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:THOMAS
Last Name:HOLEWINSKI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:664 BURLINGTON RD
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55119-5320
Mailing Address - Country:US
Mailing Address - Phone:651-730-1015
Mailing Address - Fax:
Practice Address - Street 1:664 BURLINGTON RD
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55119-5320
Practice Address - Country:US
Practice Address - Phone:651-730-1015
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN16878104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker