Healthcare Provider Details

I. General information

NPI: 1053118026
Provider Name (Legal Business Name): OXANA HOLTMANN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/27/2025
Last Update Date: 02/27/2025
Certification Date: 02/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4827 RUGBY AVE STE 301
BETHESDA MD
20814-3072
US

IV. Provider business mailing address

4827 RUGBY AVE STE 301
BETHESDA MD
20814-3072
US

V. Phone/Fax

Practice location:
  • Phone: 888-604-6776
  • Fax:
Mailing address:
  • Phone: 888-604-6776
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLGP16221
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: