MEDICARE: CHRIS HOLCOMBE M.S.

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
1	103T00000X	Psychologist		AZ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1518000322
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRIS HOLCOMBE M.S.

Provider Business Mailing Address
First Line	:	1575 W SOUTHERN AVE
Second Line	:	SUITE 6
City	:	APACHE JUNCTION
State	:	AZ
Zip	:	85220-7456
Country	:	US
Telephone Number	:	480-982-1110
Fax Number	:

Provider Business Practice Location Address
First Line	:	1575 W SOUTHERN AVE
Second Line	:	SUITE 6
City	:	APACHE JUNCTION
State	:	AZ
Zip	:	85220-7456
Country	:	US
Telephone Number	:	480-982-1110
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/14/2007
Last Update Date	:	07/26/2007

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Directions to “ CHRIS HOLCOMBE M.S.” Practice Location

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