Individual
DR. BONNIE DANSON HOLSTEIN SR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
208 OAK ST, SUITE 102, ASHLAND, OR 97520-1871
(541) 292-7536
Mailing address
2164 BIRCHWOOD LN, ASHLAND, OR 97520-1465
(541) 292-7536
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
1783
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
R140780
PTAN NUMBER FOR MEDICARE
OR
Enumeration date
07/26/2006
Last updated
04/04/2008
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