Provider Demographics
NPI:1154473973
Name:HOLMES, ESSIE LORRAINE (MA, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:ESSIE
Middle Name:LORRAINE
Last Name:HOLMES
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:93 FLORENCE LN
Mailing Address - Street 2:
Mailing Address - City:KINGSTREE
Mailing Address - State:SC
Mailing Address - Zip Code:29556-9405
Mailing Address - Country:US
Mailing Address - Phone:843-382-4080
Mailing Address - Fax:843-382-4044
Practice Address - Street 1:93 FLORENCE LN
Practice Address - Street 2:
Practice Address - City:KINGSTREE
Practice Address - State:SC
Practice Address - Zip Code:29556-9405
Practice Address - Country:US
Practice Address - Phone:843-382-4080
Practice Address - Fax:843-382-4044
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC3029235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist