Daniel Robert Holstead in Green Bay - Clinical
Daniel Robert Holstead - NPI 1104977057
Daniel Robert Holstead is a Clinical in Green Bay, Wisconsin. Daniel Robert Holstead practices all healthcare services and medical treatments related to Clinical. The NPI Number for Daniel Robert Holstead is 1104977057. The last update date is 2007-07-08.
Daniel Robert Holstead's current location address is 130 E Walnut St, Green Bay, Wisconsin. You can contact this provider via phone number 9204378256 and fax number 9204371188. The mailing address for Daniel Robert Holstead is 130 E Walnut St, Green Bay, Wisconsin. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Daniel Robert Holstead |
|---|---|
| Address | 130 E Walnut St, Green Bay, Wisconsin |
| Phone Number | 9204378256 |
| Fax Number | 9204371188 |
| Sole Proprietor | N |
| Credentials | -- |
NPI Number Detail
| NPI Number | 1104977057 |
|---|---|
| Provider Enumeration Date | 2007-01-16 |
| Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
| Address | 130 E Walnut St |
|---|---|
| City | Green Bay |
| State | Wisconsin (WI) |
| Post Code | 543014239 |
| Phone Number | 9204378256 |
| Fax Number | 9204371188 |
Provider's Primary Taxonomy Detail
| Speciality | Clinical |
|---|---|
| Taxonomy | 1041C0700X |
| Licence No | 526 |
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Definition: A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certif |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 3886098720007 | WI | BLUE CROSS | |
| 39761600 | WI | -- |
Post Comment/ Review Below
What is the unique identifier code issued to Daniel Robert Holstead by the Centers for Medicare & Medicaid Services?
The Daniel Robert Holstead has been assigned the NPI (National Provider Identifier) 1104977057. This 10-digit code serves as a unique identification number for healthcare providers issued by the Centers for Medicare & Medicaid Services (CMS).
Could you provide the complete physical address where Daniel Robert Holstead is located?
The Daniel Robert Holstead is situated at the following address: 130 E Walnut St, Green Bay, WI, 543014239.
What is Daniel Robert Holstead's specialized field of practice, and what is the corresponding taxonomy code that categorizes this area of expertise?
The area of specialization for Daniel Robert Holstead is Clinical, and the taxonomy code that classifies this field of practice is 1041C0700X.
On what date did the Daniel Robert Holstead receive the assignment of its 1104977057 from the Centers for Medicare & Medicaid Services?
The Daniel Robert Holstead was issued its 1104977057 by the Centers for Medicare & Medicaid Services on 2007-01-16.
When was the Daniel Robert Holstead's information last updated?
The Daniel Robert Holstead's information was last updated on 2007-07-08.
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