| Doctor Name: | MR. JERALD CRAIG HOLLAND |
| NPI Number: | 1043286487 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.ED., LMHC |
| License Number: | MH5407 |
| Business Practice Address: | 501 Centre St Suite 117 Fernandina Beach, FL - 320343936 |
| Business Phone Number: | 9047531563 |
| Business Fax Number: | 9044910477 |
| Mailing Address: | Po Box 916, FERNANDINA BEACH |
| State: | FL |
| Postal Code: | 320350916 |
| Phone Number: | 9047531563 |
| Fax Number: | 9044910478 |
| NPI Enumeration Date: | 02/26/2006 |
| NPI Last Update Date: | 07/09/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | MH5407 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |