Basic Information
| Provider Information | |||||||||
| NPI: | 1437633351 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HOLLAND | ||||||||
| FirstName: | MAGGIE | ||||||||
| MiddleName: | |||||||||
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| Credential: | MA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 105 112TH ST S # 135 | ||||||||
| Address2: | |||||||||
| City: | PARKLAND | ||||||||
| State: | WA | ||||||||
| PostalCode: | 984445711 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2534491095 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 105 112TH ST S # 135 | ||||||||
| Address2: | |||||||||
| City: | PARKLAND | ||||||||
| State: | WA | ||||||||
| PostalCode: | 984445711 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2534491095 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/17/2018 | ||||||||
| LastUpdateDate: | 08/17/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 05/05/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101Y00000X | Y | Behavioral Health & Social Service Providers | Counselor |
No ID Information.