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General NPI Number Information
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NPI Number | 1548267719
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Entity Type | Individual
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Provider Name | PETER F HOLMES PHD
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Gender | Male
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Dates
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Enumeration Date | 07/03/2005
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 3201 S PROVIDENCE RD SUITE 204
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City | COLUMBIA
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State | MO
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Zip | 65203-3622
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Country | US
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Telephone | 573-875-0077
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Fax |
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Provider Business Mailing Address
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Address Line | 5316 GODAS CIR
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City | COLUMBIA
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State | MO
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Zip | 65202-2980
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Country | US
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Telephone | 573-814-3632
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Fax |
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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 | 2000166307
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License Number State | MO
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