Provider Demographics
NPI:1114409513
Name:HOLLIDAY, JEREMA E (MA)
Entity Type:Individual
Prefix:
First Name:JEREMA
Middle Name:E
Last Name:HOLLIDAY
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 BRANDYWINE BLVD STE E3
Mailing Address - Street 2:
Mailing Address - City:ZANESVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43701-1138
Mailing Address - Country:US
Mailing Address - Phone:614-864-2700
Mailing Address - Fax:614-864-2702
Practice Address - Street 1:5969 E LIVINGSTON AVE STE 100
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43232-2907
Practice Address - Country:US
Practice Address - Phone:614-864-2700
Practice Address - Fax:614-864-2702
Is Sole Proprietor?:No
Enumeration Date:2018-08-31
Last Update Date:2018-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TA0700XBehavioral Health & Social Service ProvidersPsychologistAdult Development & Aging
No103TP2701XBehavioral Health & Social Service ProvidersPsychologistGroup Psychotherapy