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Individual

MR. IRVIN LEROY HOLTZHOUSE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MA, TLLP

Contact information

Practice address
651 N STATE ST, CARO, MI 48723-1543
(989) 673-5700
(989) 672-2555
Mailing address
443 N STATE ST, CARO, MI 48723-1539
(989) 672-6160
(989) 672-5649

Taxonomy

Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
6301015082
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
7509107840
BCBS
MI
01
7509109640
BCBS
MI
01
7509109660
BCBS
MI
Enumeration date
06/04/2012
Last updated
06/04/2012
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