Doctor Name: | KAISHA HOLMES |
NPI Number: | 1376602847 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LSW |
License Number: | SW122337 |
Business Practice Address: | 4201 W 5th St Marcus Hook, PA - 190615005 |
Business Phone Number: | 6109389378 |
Business Fax Number: | |
Mailing Address: | 4201 W 5th St, MARCUS HOOK |
State: | PA |
Postal Code: | 190615005 |
Phone Number: | 6109389378 |
Fax Number: | |
NPI Enumeration Date: | 12/08/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041S0200X |
License Number: | SW122337 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | School |
Taxonomy Definition: |