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General NPI Number Information
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NPI Number | 1265510283
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Entity Type | Individual
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Provider Name | DEBORAH ANN HOLMES PH.D.
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Gender | Female
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Dates
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Enumeration Date | 11/01/2006
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Last Update Date | 07/13/2020
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Provider Practice Location Address
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Address Line | 1107 E 13TH ST STE E
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City | GROVE
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State | OK
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Zip | 74344-7956
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Country | US
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Telephone | 918-791-3610
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Fax | 918-791-3612
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Provider Business Mailing Address
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Address Line | PO BOX 450916
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City | GROVE
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State | OK
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Zip | 74345-0916
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Country | US
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Telephone | 918-791-3610
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Fax | 918-791-3612
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number | 692
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License Number State | OK
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Taxonomy #2
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 692
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License Number State | OK
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