Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103TB0200X | Cognitive & Behavioral Psychologist | 20043277B | IN |
Y | 103G00000X | Clinical Psychologist | 20043277B | IN |
Y | 103TC0700X | Clinical Psychologist | 20043277B | IN |
NPI | 1003467515 |
---|---|
Provider Name | Dr. Jennifer Holzman |
First Address | Indianapolis, IN 46202-3277 |
Second Address | Indianapolis, IN 46240-1564 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/09/2019 |
Last Update Date | 25/09/2019 |