Individual
DANIEL ROBERT HOLSTEAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
130 E WALNUT ST, SUITE 706, GREEN BAY, WI 54301-4239
(920) 437-8256
(920) 437-1188
Mailing address
130 E WALNUT ST, SUITE 706, GREEN BAY, WI 54301-4239
(920) 437-8256
(920) 437-1188
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
526
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3886098720007
BLUE CROSS
WI
05
—
39761600
—
WI
Enumeration date
01/16/2007
Last updated
07/08/2007
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