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NPI Code Detail

MEDICARE: MONICA HOLMES

MEDICARE: MONICA HOLMES
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor
2171M00000XCase Manager/Care Coordinator

General Provider Information

NPI Number : 1396235081
Entity Type Code : Individual
Provider Name (Legal Business Name) : MONICA HOLMES
Provider Business Mailing Address
First Line : 7330 FERN AVE STE 1102
Second Line :
City : SHREVEPORT
State : LA
Zip : 71105-4989
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 7330 FERN AVE STE 1102
Second Line :
City : SHREVEPORT
State : LA
Zip : 71105-4989
Country : US
Telephone Number : 318-524-9954
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/17/2018
Last Update Date : 06/12/2019

Similar Medicare Providers

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1578070819 — KIMBERLY BROOKS
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1982197851 — ELISIA MINTON
Practice Location Address:
7330 FERN AVE STE 1102
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71105-4989
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Practice Fax: 318-524-9953

Directions to “ MONICA HOLMES ” Practice Location

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