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NPI Code Detail

MEDICARE: BRUCE JUNIOR HOLMES

MEDICARE:   BRUCE JUNIOR HOLMES
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
1101YS0200XSchool CounselorDC

General Provider Information

NPI Number : 1194181081
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRUCE JUNIOR HOLMES
Provider Business Mailing Address
First Line : 1217 W VIRGINIA AVE NE
Second Line :
City : WASHINGTON
State : DC
Zip : 20002-3817
Country : US
Telephone Number : 202-397-1614
Fax Number : 202-398-4832
Provider Business Practice Location Address
First Line : 1217 W VIRGINIA AVE NE
Second Line :
City : WASHINGTON
State : DC
Zip : 20002-3817
Country : US
Telephone Number : 202-397-1614
Fax Number : 202-398-4832
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/07/2016
Last Update Date : 01/07/2016

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Directions to “ BRUCE JUNIOR HOLMES ” Practice Location

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