Holman, Roberta L

Holman, Roberta L is an individual health care provider with primary practice located at 409 County Road R , Black River Falls WI 54615-5129. She recently has only one registered license in Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), which is considered as her primary health care specialty. Holman, Roberta L can be contacted via phone (715) 284-9477.

Contact Information

Primary practice address
409 County Road R Black River Falls WI 54615-5129
Phone: (715) 284-9477
Fax: (715) 284-5547
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X

Profile Details

NPI number 1518020403
LBN Legal business name Holman, Roberta L
Credentials MS, CADC
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 19th, 2006
Last updated Sep 7th, 2011 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1518020403 NPPES
Other 51172 SECURITY HEALTH PLAN
Other HP80839 SECURITY HEALTH PLAN
MEDICAID 39728900 SECURITY HEALTH PLAN

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