Provider Demographics
NPI:1538442819
Name:HOLTZ, ERICA SAMANTHA (LMFT, MA)
Entity type:Individual
Prefix:MS
First Name:ERICA
Middle Name:SAMANTHA
Last Name:HOLTZ
Suffix:
Gender:F
Credentials:LMFT, MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 BUCK RD
Mailing Address - Street 2:UNIT 500 SUITE #4
Mailing Address - City:HUNTINGDON VALLEY
Mailing Address - State:PA
Mailing Address - Zip Code:19006-1544
Mailing Address - Country:US
Mailing Address - Phone:215-680-1128
Mailing Address - Fax:
Practice Address - Street 1:111 BUCK RD
Practice Address - Street 2:UNIT 500 SUITE #4
Practice Address - City:HUNTINGDON VALLEY
Practice Address - State:PA
Practice Address - Zip Code:19006-1544
Practice Address - Country:US
Practice Address - Phone:215-680-1128
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-23
Last Update Date:2011-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMF000609106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist