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NPI Code Detail

MEDICARE: LAURA RENAE HOLLAND MSW, LSW

MEDICARE: LAURA RENAE HOLLAND MSW, LSW
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 WorkerS.1600936OH

General Provider Information

NPI Number : 1437693231
Entity Type Code : Individual
Provider Name (Legal Business Name) : LAURA RENAE HOLLAND MSW, LSW
Provider Business Mailing Address
First Line : 13201 GRANGER RD
Second Line :
City : GARFIELD HEIGHTS
State : OH
Zip : 44125-1978
Country : US
Telephone Number : 330-418-7163
Fax Number :
Provider Business Practice Location Address
First Line : 13201 GRANGER RD
Second Line :
City : GARFIELD HEIGHTS
State : OH
Zip : 44125-1978
Country : US
Telephone Number : 216-831-2255
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/13/2016
Last Update Date : 08/05/2024

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