MEDICARE: MS. KIMBERLY LYNN HOLLAND L.P.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	0701002352	VA

General Provider Information

NPI Number	:	1437122496
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. KIMBERLY LYNN HOLLAND L.P.C.

Provider Business Mailing Address
First Line	:	226 MEADOW LANE
Second Line	:
City	:	COLLINSVILLE
State	:	VA
Zip	:	24078
Country	:	US
Telephone Number	:	276-352-5115
Fax Number	:	276-622-2099

Provider Business Practice Location Address
First Line	:	226 MEADOW LANE
Second Line	:
City	:	COLLINSVILLE
State	:	VA
Zip	:	24078
Country	:	US
Telephone Number	:	276-352-5115
Fax Number	:	276-622-2099

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/09/2006
Last Update Date	:	11/11/2021

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