Provider Demographics
NPI:1154604098
Name:HOLTZ AND WHITE MARRIAGE AND FAMILY SERVICES
Entity type:Organization
Organization Name:HOLTZ AND WHITE MARRIAGE AND FAMILY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MARRIAGE AND FAMILY THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:ERICA
Authorized Official - Middle Name:SAMANTHA
Authorized Official - Last Name:HOLTZ
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:215-680-1128
Mailing Address - Street 1:111 BUCK RD
Mailing Address - Street 2:UNIT 500 SUITE 4
Mailing Address - City:HUNTINGDON VALLEY
Mailing Address - State:PA
Mailing Address - Zip Code:19006-1544
Mailing Address - Country:US
Mailing Address - Phone:215-680-1128
Mailing Address - Fax:
Practice Address - Street 1:111 BUCK RD
Practice Address - Street 2:UNIT 500 SUITE 4
Practice Address - City:HUNTINGDON VALLEY
Practice Address - State:PA
Practice Address - Zip Code:19006-1544
Practice Address - Country:US
Practice Address - Phone:215-680-1128
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-27
Last Update Date:2011-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMF000609106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty