MEDICARE: JENNIFER 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	106S00000X	Behavior Technician	RBT-20-139824
2	103K00000X	Behavior Analyst	1-26-87025	TX
3	106S00000X	Behavior Technician

General Provider Information

NPI Number	:	1982203600
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER HOLMES

Provider Business Mailing Address
First Line	:	25428 DEVONSHIRE KNOLL ST
Second Line	:
City	:	KATY
State	:	TX
Zip	:	77493-3189
Country	:	US
Telephone Number	:	409-550-0860
Fax Number	:

Provider Business Practice Location Address
First Line	:	25428 DEVONSHIRE KNOLL ST
Second Line	:
City	:	KATY
State	:	TX
Zip	:	77493-3189
Country	:	US
Telephone Number	:	409-550-0860
Fax Number	:

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

Provider Enumeration Date	:	10/23/2020
Last Update Date	:	01/20/2026

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Directions to “ JENNIFER HOLMES ” Practice Location

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