Provider Information for 1376958199
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Mrs. GLORIA TEMPLE HOLLAND MA, LSW, LMFT
Sex: Female
NPI: 1376958199
Last Updated: 2014-07-01
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NPI | 1376958199 | ||||||||||||
| Enumeration Date | 2014-07-01 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | NO | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | 247 OLD PLANTERS RD PLANTERSVILLE, MS 38862-6200 United States Phone: 662-377-2865 | Fax:662-377-2844 | ||||||||||||
| Primary Practice Address | 4579 S EASON BLVD TUPELO, MS 38801-6539 United States Phone: 662-377-2865 | Fax:662-377-2844 | ||||||||||||
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