Healthcare Provider Details

I. General information

NPI: 1164961132
Provider Name (Legal Business Name): NOELLE HOLMES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/23/2017
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

540 S COLLEGE AVE STE 160
NEWARK DE
19713-1302
US

IV. Provider business mailing address

540 S COLLEGE AVE STE 160
NEWARK DE
19713-1302
US

V. Phone/Fax

Practice location:
  • Phone: 302-831-3000
  • Fax: 302-831-4468
Mailing address:
  • Phone: 302-831-3000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberU1-0000756
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: