Individual
GARY S HOLDEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CADCIII
Contact information
Practice address
412 W KINNE ST, ELLSWORTH, WI 54011
(715) 273-6770
(715) 273-6862
Mailing address
PO BOX 670, ELLSWORTH, WI 54011-0670
(715) 273-6770
(715) 273-6862
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
2028
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
39381400
—
WI
01
—
920461040138
PREFERRED ONE
MN
Enumeration date
11/15/2006
Last updated
07/09/2007
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