MEDICARE: MARCIA ANNE 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
1	103K00000X	Behavior Analyst	1-26-89882	KY

General Provider Information

NPI Number	:	1639827363
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARCIA ANNE HOLMES

Provider Business Mailing Address
First Line	:	805 ALEXA DR
Second Line	:
City	:	MT STERLING
State	:	KY
Zip	:	40353-1000
Country	:	US
Telephone Number	:	859-286-6750
Fax Number	:

Provider Business Practice Location Address
First Line	:	805 ALEXA DR
Second Line	:
City	:	MT STERLING
State	:	KY
Zip	:	40353-1000
Country	:	US
Telephone Number	:	859-286-6750
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/11/2022
Last Update Date	:	05/13/2026

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