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Individual

HAROLD HOLDER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
BA PSYCH, BSW, MSW

Contact information

Practice address
2800 JOE DIMAGGIO BLVD UNIT 40, ROUND ROCK, TX 78665-3951
(585) 510-9625
Mailing address
703 GLENMOSE RD, FAIRPORT, NY 14450-3865
(158) 551-0962

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
21230609
NY
1041C0700X
Clinical Social Worker
Primary
804426

Other

Enumeration date
11/17/2021
Last updated
12/05/2021
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