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General NPI Number Information
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NPI Number | 1447740972
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Entity Type | Individual
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Provider Name | WENDIE SUE HOLLAND PH.D.
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Gender | Female
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Dates
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Enumeration Date | 05/10/2018
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Last Update Date | 05/10/2018
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Provider Practice Location Address
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Address Line | 389 ANNABLE POINT RD
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City | CENTERVILLE
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State | MA
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Zip | 02632-2401
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Country | US
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Telephone | 774-487-2535
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Fax |
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Provider Business Mailing Address
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Address Line | 389 ANNABLE POINT RD
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City | CENTERVILLE
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State | MA
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Zip | 02632-2401
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Country | US
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Telephone | 774-487-2535
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 7624
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License Number State | MA
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