MEDICARE: DR. BARBARA MINTZ HOLLANDER EDD

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	103TC1900X	Counseling Psychologist	3426	OH

General Provider Information

NPI Number	:	1750439931
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BARBARA MINTZ HOLLANDER EDD

Provider Business Mailing Address
First Line	:	5335 FAR HILLS AVE
Second Line	:	SUITE 312
City	:	DAYTON
State	:	OH
Zip	:	45429-2350
Country	:	US
Telephone Number	:	937-291-0100
Fax Number	:	937-890-0228

Provider Business Practice Location Address
First Line	:	5335 FAR HILLS AVE
Second Line	:	SUITE 312
City	:	DAYTON
State	:	OH
Zip	:	45429-2350
Country	:	US
Telephone Number	:	937-291-0100
Fax Number	:	937-890-0228

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

Provider Enumeration Date	:	01/06/2007
Last Update Date	:	07/08/2007

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