Provider Demographics
NPI:1235370792
Name:HOLIDAY-JAMES, KIA T (EDD)
Entity Type:Individual
Prefix:DR
First Name:KIA
Middle Name:T
Last Name:HOLIDAY-JAMES
Suffix:
Gender:F
Credentials:EDD
Other - Prefix:DR
Other - First Name:KIA
Other - Middle Name:T
Other - Last Name:HOLIDAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:EDD
Mailing Address - Street 1:8461 SNOWDEN OAKS PL
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20708-2301
Mailing Address - Country:US
Mailing Address - Phone:301-470-0025
Mailing Address - Fax:
Practice Address - Street 1:8461 SNOWDEN OAKS PL
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20708-2301
Practice Address - Country:US
Practice Address - Phone:301-470-0025
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-13
Last Update Date:2009-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC2088101YP2500X
DCPRC13897101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional