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General NPI Number Information
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NPI Number | 1689223364
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Entity Type | Individual
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Provider Name | ANGELA W HOLIDAY
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Gender | Female
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Dates
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Enumeration Date | 09/05/2019
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Last Update Date | 09/05/2019
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Provider Practice Location Address
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Address Line | 9800 HILLWOOD PKWY STE 140
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City | FORT WORTH
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State | TX
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Zip | 76177-1532
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Country | US
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Telephone | 469-215-5106
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Fax |
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Provider Business Mailing Address
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Address Line | 6051 DAVIS BLVD # 821277
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City | NORTH RICHLAND HILLS
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State | TX
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Zip | 76180-6385
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Country | US
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Telephone | 903-261-2726
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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 | 76576
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License Number State | TX
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