Provider Demographics
NPI:1316436660
Name:HOLZENDORF, SHERONDA NICOLE (TCM)
Entity type:Individual
Prefix:MRS
First Name:SHERONDA
Middle Name:NICOLE
Last Name:HOLZENDORF
Suffix:
Gender:F
Credentials:TCM
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:2392 EDGEWOOD AVE N
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32254-1725
Mailing Address - Country:US
Mailing Address - Phone:904-781-7797
Mailing Address - Fax:904-781-8684
Practice Address - Street 1:5559 VERBENA RD
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32209-2418
Practice Address - Country:US
Practice Address - Phone:917-412-0085
Practice Address - Fax:904-396-9100
Is Sole Proprietor?:No
Enumeration Date:2018-05-02
Last Update Date:2018-05-02
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker