Provider Demographics
NPI:1093583213
Name:HOLMES, NAOMI ELIZABETH
Entity Type:Individual
Prefix:
First Name:NAOMI
Middle Name:ELIZABETH
Last Name:HOLMES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 W BAY RD
Mailing Address - Street 2:
Mailing Address - City:OSTERVILLE
Mailing Address - State:MA
Mailing Address - Zip Code:02655-2447
Mailing Address - Country:US
Mailing Address - Phone:508-364-9520
Mailing Address - Fax:
Practice Address - Street 1:15 W BAY RD
Practice Address - Street 2:
Practice Address - City:OSTERVILLE
Practice Address - State:MA
Practice Address - Zip Code:02655-2447
Practice Address - Country:US
Practice Address - Phone:508-364-9520
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-18
Last Update Date:2023-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA17581225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist