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General NPI Number Information
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NPI Number | 1801018510
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Entity Type | Individual
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Provider Name | TERI L HOLTER LCSW, DCSW
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Gender | Female
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Dates
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Enumeration Date | 05/03/2007
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Last Update Date | 08/12/2016
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Provider Practice Location Address
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Address Line | 1170 MAKAWAO AVE
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City | MAKAWAO
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State | HI
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Zip | 96768-9448
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Country | US
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Telephone | 808-572-5551
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Fax | 808-572-5554
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Provider Business Mailing Address
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Address Line | PO BOX 458
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City | MAKAWAO
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State | HI
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Zip | 96768-0458
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Country | US
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Telephone | 808-205-8055
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LCSW-1076
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License Number State | HI
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