MEDICARE: MR. ARONZO HOLLAND

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
1	101Y00000X	Counselor

General Provider Information

NPI Number	:	1306261722
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. ARONZO HOLLAND

Provider Business Mailing Address
First Line	:	7719 CAMFIELD CT
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46236-9695
Country	:	US
Telephone Number	:	317-694-5388
Fax Number	:	317-926-0603

Provider Business Practice Location Address
First Line	:	4954 E 56TH ST
Second Line	:	119
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46220-5773
Country	:	US
Telephone Number	:	317-694-5388
Fax Number	:	317-926-0603

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/21/2014
Last Update Date	:	02/21/2014

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Directions to “ MR. ARONZO HOLLAND ” Practice Location

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