Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor | ||
N | 101YP1600X | Pastoral Counselor |
NPI | 1104214105 |
---|---|
Provider Name | Ms. Chimere Holmes |
First Address | West Chester, PA 19380-2938 |
Second Address | Philadelphia, PA 19102-4908 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/12/2014 |
Last Update Date | 15/01/2015 |