Provider Demographics
NPI:1295098655
Name:HOLDER, GENIEVE ANN
Entity type:Individual
Prefix:MRS
First Name:GENIEVE
Middle Name:ANN
Last Name:HOLDER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:72 BUCKINGHAM CT
Mailing Address - Street 2:
Mailing Address - City:POMONA
Mailing Address - State:NY
Mailing Address - Zip Code:10970-3704
Mailing Address - Country:US
Mailing Address - Phone:845-362-1544
Mailing Address - Fax:
Practice Address - Street 1:72 BUCKINGHAM CT
Practice Address - Street 2:
Practice Address - City:POMONA
Practice Address - State:NY
Practice Address - Zip Code:10970-3704
Practice Address - Country:US
Practice Address - Phone:845-362-1544
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-20
Last Update Date:2012-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst