Individual
JOHANNA HOLLIDAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
591 POQUONNOCK RD, GROTON, CT 06340-4571
(860) 449-8217
Mailing address
255 HEMPSTEAD ST, NEW LONDON, CT 06320-6204
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
001900
CT
Other
Enumeration date
10/11/2007
Last updated
10/20/2010
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