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NPI Code Detail

MEDICARE: MS. JUDY O. HOLLAND LCSW

MEDICARE:  MS. JUDY O. HOLLAND  LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker1662LA

General Provider Information

NPI Number : 1053415489
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. JUDY O. HOLLAND LCSW
Provider Business Mailing Address
First Line : 11924 JUSTICE AVE.
Second Line : STE. A
City : BATON ROUGE
State : LA
Zip : 70816-2372
Country : US
Telephone Number : 225-291-6647
Fax Number : 225-291-9463
Provider Business Practice Location Address
First Line : 11924 JUSTICE AVE.
Second Line : STE. A
City : BATON ROUGE
State : LA
Zip : 70816-2372
Country : US
Telephone Number : 225-291-6647
Fax Number : 225-291-9463
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/07/2006
Last Update Date : 07/08/2007

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Directions to “ MS. JUDY O. HOLLAND LCSW” Practice Location

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