Doctor Name: | ERIC HOLMES |
NPI Number: | 1053755868 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | J081056657 |
Business Practice Address: | 1705 Cradduck Rd Ada, OK - 748209491 |
Business Phone Number: | 5803109000 |
Business Fax Number: | |
Mailing Address: | 3622 Governor Harris Dr, ADA |
State: | OK |
Postal Code: | 748209258 |
Phone Number: | 9183120450 |
Fax Number: | |
NPI Enumeration Date: | 04/23/2013 |
NPI Last Update Date: | 11/21/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | J081056657 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OK |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |