Provider Demographics
NPI:1427159284
Name:HOLDEN, NANCY LYNN (MSLP)
Entity type:Individual
Prefix:MRS
First Name:NANCY
Middle Name:LYNN
Last Name:HOLDEN
Suffix:
Gender:F
Credentials:MSLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 2ND ST S
Mailing Address - Street 2:SUITE 222
Mailing Address - City:WAITE PARK
Mailing Address - State:MN
Mailing Address - Zip Code:56387
Mailing Address - Country:US
Mailing Address - Phone:320-259-7022
Mailing Address - Fax:320-259-7022
Practice Address - Street 1:110 2ND ST S
Practice Address - Street 2:SUITE 222
Practice Address - City:WAITE PARK
Practice Address - State:MN
Practice Address - Zip Code:56387
Practice Address - Country:US
Practice Address - Phone:320-259-7022
Practice Address - Fax:320-259-7022
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNLP0936103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
Provider Identifiers
StateIdentifier IDID TypeIssuer
6229337OtherUBH MEDICA
MN77178HOOtherBCBS