Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TA0700X | Adult Development & Aging Psychologist | ||
N | 103TP2701X | Group Psychotherapist |
NPI | 1114409513 |
---|---|
Provider Name | Jerema E Holliday |
First Address | Zanesville, OH 43701-1138 |
Second Address | Columbus, OH 43232-2907 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/08/2018 |
Last Update Date | 31/08/2018 |