Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 102L00000X | Psychologist | 6301002855 | MI |
N | 103T00000X | Psychologist | 6301002855 | MI |
N | 103TC2200X | Clinical Child & Adolescent Psychologist | 6301002855 | MI |
NPI | 1083768147 |
---|---|
Provider Name | Dr. Loren E. Hollander |
First Address | Oak Park, MI 48237-1159 |
Second Address | Royal Oak, MI 48073-0979 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/01/2007 |
Last Update Date | 08/07/2007 |