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:
Health care specialties
| Specialty | Code | License # | 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 13 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1518020403 | NPPES |
| Other | 51172 | SECURITY HEALTH PLAN | |
| Other | HP80839 | SECURITY HEALTH PLAN | |
| MEDICAID | 39728900 | SECURITY HEALTH PLAN |
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