Individual
MR. JEFFREY HOLLAND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
509 CARDENAS DR SE, ALBUQUERQUE, NM 87108-3721
(505) 268-3372
Mailing address
5421 SUMMER AVE NE, ALBUQUERQUE, NM 87110-6435
(505) 261-8715
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
C-09763
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
89729811
—
NM
Enumeration date
10/06/2016
Last updated
02/27/2023
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