Healthcare Provider Details

I. General information

NPI: 1679800064
Provider Name (Legal Business Name): BARBARA G HOLLAND LAADC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/06/2009
Last Update Date: 10/22/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

559 E BARDSLEY AVE
TULARE CA
93274-5400
US

IV. Provider business mailing address

1032 W CORTNER ST
HANFORD CA
93230-1663
US

V. Phone/Fax

Practice location:
  • Phone: 559-688-7531
  • Fax:
Mailing address:
  • Phone: 559-309-4353
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number02-118197
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: