Healthcare Provider Details

I. General information

NPI: 1124464193
Provider Name (Legal Business Name): LINDSAY ERMINIA HOLLAND LADC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/17/2013
Last Update Date: 05/17/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

420 S ROCK BLVD
SPARKS NV
89431-5547
US

IV. Provider business mailing address

PO BOX 10765
RENO NV
89510-0765
US

V. Phone/Fax

Practice location:
  • Phone: 775-358-1123
  • Fax: 775-358-9391
Mailing address:
  • Phone: 775-358-1123
  • Fax: 775-358-9391

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberLADC 852-L
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: