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General NPI Number Information
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NPI Number | 1487077814
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Entity Type | Individual
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Provider Name | LETICIA MARIE HOLLEMAN LICSW
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Gender | Female
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Dates
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Enumeration Date | 01/21/2014
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Last Update Date | 06/03/2024
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Provider Practice Location Address
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Address Line | 9040 JACKSON AVE
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City | TACOMA
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State | WA
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Zip | 98431-1703
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Country | US
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Telephone | 253-968-2252
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Fax | 253-851-3188
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Provider Business Mailing Address
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Address Line | 14951 NW SEAVIEW DR
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City | SEABECK
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State | WA
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Zip | 98380-9755
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Country | US
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Telephone | 425-903-1119
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Fax | 253-851-3188
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | LW60861543
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License Number State | WA
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