Provider Demographics
NPI:1114611217
Name:HOLMES, BRIANNA M (LPC)
Entity Type:Individual
Prefix:
First Name:BRIANNA
Middle Name:M
Last Name:HOLMES
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3136 S BEAR CLAW WAY
Mailing Address - Street 2:
Mailing Address - City:MERIDIAN
Mailing Address - State:ID
Mailing Address - Zip Code:83642-8157
Mailing Address - Country:US
Mailing Address - Phone:385-222-5520
Mailing Address - Fax:
Practice Address - Street 1:3136 S BEAR CLAW WAY
Practice Address - Street 2:
Practice Address - City:MERIDIAN
Practice Address - State:ID
Practice Address - Zip Code:83642-8157
Practice Address - Country:US
Practice Address - Phone:385-222-5520
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-05
Last Update Date:2023-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health