Individual
LIDA A HOLST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
670 PARK AVE, SHELBY, MT 59474-1663
(406) 434-3110
(406) 434-3143
Mailing address
PO BOX 10187, ALBANY, NY 12201-5187
(207) 777-4111
(207) 783-6660
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
MC16835
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
40408
MT LICENSE
MT
Enumeration date
10/19/2017
Last updated
03/12/2021
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