Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TB0200X | Cognitive & Behavioral Psychologist |
NPI | 1154588879 |
---|---|
Provider Name | Robyn L Holmes |
First Address | Manchester, MO 63021-5453 |
Second Address | Manchester, MO 63021-5453 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/05/2008 |
Last Update Date | 20/05/2008 |