MEDICARE: CORI HOLLAND

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	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1518791938
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CORI HOLLAND

Provider Business Mailing Address
First Line	:	3012 N 15TH ST
Second Line	:
City	:	TACOMA
State	:	WA
Zip	:	98406-6410
Country	:	US
Telephone Number	:	253-446-7176
Fax Number	:

Provider Business Practice Location Address
First Line	:	6602 E CARONDELET DR
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85710-2119
Country	:	US
Telephone Number	:	520-524-4757
Fax Number	:

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

Provider Enumeration Date	:	08/28/2024
Last Update Date	:	12/07/2025

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Directions to “ CORI HOLLAND ” Practice Location

Language	Start Address	Practice Location

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