Provider Demographics
NPI:1669781969
Name:HOLWAGER, NORMA JEAN (LCPC)
Entity type:Individual
Prefix:
First Name:NORMA
Middle Name:JEAN
Last Name:HOLWAGER
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 GRANT DR
Mailing Address - Street 2:
Mailing Address - City:CUMBERLAND
Mailing Address - State:MD
Mailing Address - Zip Code:21502-7217
Mailing Address - Country:US
Mailing Address - Phone:301-729-4027
Mailing Address - Fax:301-729-0804
Practice Address - Street 1:11 GRANT DR
Practice Address - Street 2:
Practice Address - City:CUMBERLAND
Practice Address - State:MD
Practice Address - Zip Code:21502-7217
Practice Address - Country:US
Practice Address - Phone:301-729-4027
Practice Address - Fax:301-729-0804
Is Sole Proprietor?:No
Enumeration Date:2010-10-04
Last Update Date:2010-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC1061101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional