Basic Information
| Provider Information | |||||||||
| NPI: | 1841478849 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HOLLAND | ||||||||
| FirstName: | APRIL | ||||||||
| MiddleName: | A | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2951 RED BANKS RD N | ||||||||
| Address2: | |||||||||
| City: | BYHALIA | ||||||||
| State: | MS | ||||||||
| PostalCode: | 386117982 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9013361061 | ||||||||
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| Practice Location | |||||||||
| Address1: | 152 HIGHWAY 7 S | ||||||||
| Address2: | |||||||||
| City: | OXFORD | ||||||||
| State: | MS | ||||||||
| PostalCode: | 386555392 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6622347521 | ||||||||
| FaxNumber: | 6622363071 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/01/2008 | ||||||||
| LastUpdateDate: | 02/01/2008 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | 1805 | MS | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health | 101YM0800X | 2021 | TN | N | Behavioral Health & Social Service Providers | Counselor | Mental Health |
ID Information
| ID | Type | State | Issuer | Description | 00018202 | 05 | MS | MEDICAID |