Individual
SANDRA A HOLDEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW, MSW, SAP
Contact information
Practice address
2640 W POINT RD, GREEN BAY, WI 54304-1344
(920) 869-2711
Mailing address
PO BOX 365, ONEIDA, WI 54155-0365
(920) 869-2711
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
1819
WI
1041C0700X
Clinical Social Worker
Primary
#1819
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
39773600
—
WI
Enumeration date
10/27/2005
Last updated
05/18/2010
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