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General NPI Number Information
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NPI Number | 1487316048
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Entity Type | Individual
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Provider Name | SIERRA P HOLTZ
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Gender | Female
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Dates
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Enumeration Date | 10/12/2021
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Last Update Date | 10/12/2021
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Provider Practice Location Address
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Address Line | 1216 W MAIN ST
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City | OWOSSO
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State | MI
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Zip | 48867-2040
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Country | US
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Telephone | 989-723-5877
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Fax |
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Provider Business Mailing Address
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Address Line | 5012 LINDEN RD
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City | SWARTZ CREEK
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State | MI
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Zip | 48473-8206
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Country | US
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Telephone | 817-908-9994
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 6451018575
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License Number State | MI
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