Provider Demographics
NPI:1346084365
Name:HOLLAND, TASHA
Entity type:Individual
Prefix:
First Name:TASHA
Middle Name:
Last Name:HOLLAND
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1803 WATTS LN
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23223-1925
Mailing Address - Country:US
Mailing Address - Phone:804-723-1295
Mailing Address - Fax:
Practice Address - Street 1:1803 WATTS LN
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23223-1925
Practice Address - Country:US
Practice Address - Phone:804-723-1295
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-24
Last Update Date:2025-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA343900000X
101Y00000X
VA0732010581101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No101Y00000XBehavioral Health & Social Service ProvidersCounselor