Provider Demographics
NPI:1902320260
Name:HOLDER, RYAN (LMHC)
Entity Type:Individual
Prefix:
First Name:RYAN
Middle Name:
Last Name:HOLDER
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:197 LONG POND RD
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:NH
Mailing Address - Zip Code:03819-3127
Mailing Address - Country:US
Mailing Address - Phone:603-382-4661
Mailing Address - Fax:603-382-0571
Practice Address - Street 1:197 LONG POND RD
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:NH
Practice Address - Zip Code:03819-3127
Practice Address - Country:US
Practice Address - Phone:603-382-4661
Practice Address - Fax:603-382-0571
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-28
Last Update Date:2017-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH1245101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty