Healthcare Provider Details

I. General information

NPI: 1467264457
Provider Name (Legal Business Name): ISABELLA EMMA HOLMGREN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/25/2025
Last Update Date: 06/11/2026
Certification Date: 06/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

970 HOPE ST UNIT 3
BRISTOL RI
02809-5210
US

IV. Provider business mailing address

143 BRADFORD ST APT 3
BRISTOL RI
02809-2389
US

V. Phone/Fax

Practice location:
  • Phone: 401-558-7724
  • Fax:
Mailing address:
  • Phone: 401-558-7724
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: