Provider Demographics
NPI:1114766649
Name:CARDER, HOLLY DEANN (COMMTY HTH WKR)
Entity type:Individual
Prefix:
First Name:HOLLY
Middle Name:DEANN
Last Name:CARDER
Suffix:
Gender:F
Credentials:COMMTY HTH WKR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1815 W MARKET ST STE 301
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44313-7067
Mailing Address - Country:US
Mailing Address - Phone:330-842-9870
Mailing Address - Fax:330-678-3677
Practice Address - Street 1:2114 SPRINGFIELD CENTER RD
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44312-1935
Practice Address - Country:US
Practice Address - Phone:330-962-6334
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-23
Last Update Date:2024-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health