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General NPI Number Information
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NPI Number | 1902794332
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Entity Type | Individual
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Provider Name | SHANDRA HOLLAND LPC-A
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Gender | Female
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Dates
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Enumeration Date | 06/25/2025
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Last Update Date | 06/25/2025
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Provider Practice Location Address
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Address Line | 2379 GUS THOMASSON RD STE 300
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City | MESQUITE
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State | TX
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Zip | 75150-7102
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Country | US
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Telephone | 972-882-6344
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Fax |
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Provider Business Mailing Address
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Address Line | 2027 CHILDRESS DR
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City | FORNEY
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State | TX
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Zip | 75126-5180
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Country | US
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Telephone | 469-630-4341
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 98341
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License Number State | TX
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