Provider Demographics
NPI:1083736425
Name:HOLMES, PAMELA D (MS, LMHC)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:D
Last Name:HOLMES
Suffix:
Gender:F
Credentials:MS, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1187
Mailing Address - Street 2:
Mailing Address - City:CHEWELAH
Mailing Address - State:WA
Mailing Address - Zip Code:99109-1187
Mailing Address - Country:US
Mailing Address - Phone:509-935-4023
Mailing Address - Fax:509-935-4026
Practice Address - Street 1:301 E CLAY AVE
Practice Address - Street 2:SUITE #220
Practice Address - City:CHEWELAH
Practice Address - State:WA
Practice Address - Zip Code:99109-8936
Practice Address - Country:US
Practice Address - Phone:509-935-4023
Practice Address - Fax:509-935-4026
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH00007595101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health