Provider Demographics
NPI:1487464541
Name:HOLFELDER, ANNIE LAURIE C
Entity type:Individual
Prefix:
First Name:ANNIE LAURIE
Middle Name:C
Last Name:HOLFELDER
Suffix:
Gender:X
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:191 MAPLE RD
Mailing Address - Street 2:
Mailing Address - City:DAISYTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:15427-1131
Mailing Address - Country:US
Mailing Address - Phone:724-992-4696
Mailing Address - Fax:
Practice Address - Street 1:205 S DUFFY RD STE B
Practice Address - Street 2:
Practice Address - City:BUTLER
Practice Address - State:PA
Practice Address - Zip Code:16001-2789
Practice Address - Country:US
Practice Address - Phone:724-256-9881
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-10
Last Update Date:2025-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health