Doctor Name: | MRS. REBECCA LYNN HOLDERMAN |
NPI Number: | 1407236169 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | ED. S. |
License Number: | |
Business Practice Address: | 90 S Tippecanoe Dr Tipp City, OH - 453711139 |
Business Phone Number: | 9376678444 |
Business Fax Number: | |
Mailing Address: | 90 S. Tippecanoe Dr, TIPP CITY |
State: | OH |
Postal Code: | 45371 |
Phone Number: | 9376678444 |
Fax Number: | |
NPI Enumeration Date: | 06/08/2015 |
NPI Last Update Date: | 06/08/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TS0200X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OH |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | School |
Taxonomy Definition: |