Healthcare Provider Details

I. General information

NPI: 1215032909
Provider Name (Legal Business Name): ARLENE D HOULDIN PHD, APRN, BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/14/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

420 SERVICE DR
PHILADELPHIA PA
19104-4210
US

IV. Provider business mailing address

3531 RUNNYMEADE DR
NEWTOWN SQUARE PA
19073-3050
US

V. Phone/Fax

Practice location:
  • Phone: 215-898-1821
  • Fax:
Mailing address:
  • Phone: 610-353-7674
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0809X
TaxonomyAdult Psychiatric/Mental Health Registered Nurse
License NumberRN178933L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: