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General NPI Number Information
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NPI Number | 1659495893
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Entity Type | Individual
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Provider Name | SUSAN L. HOLLADA L.S.W.
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Gender | Female
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Dates
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Enumeration Date | 03/16/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 4801 DRESSLER RD NW SUITE 130
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City | CANTON
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State | OH
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Zip | 44718-3667
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Country | US
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Telephone | 330-649-7373
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Fax | 330-649-7377
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Provider Business Mailing Address
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Address Line | 320 S SILVER ST
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City | LOUISVILLE
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State | OH
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Zip | 44641-1952
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Country | US
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Telephone | 330-649-7373
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Fax | 330-649-7377
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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 | S.0026584
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License Number State | OH
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