Provider Demographics
NPI:1346585965
Name:HOLIMAN, MERANDA LYNN (LMT)
Entity Type:Individual
Prefix:MRS
First Name:MERANDA
Middle Name:LYNN
Last Name:HOLIMAN
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8017 JEFFERSON HWY
Mailing Address - Street 2:STE A2
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70809
Mailing Address - Country:US
Mailing Address - Phone:225-405-7430
Mailing Address - Fax:225-928-8485
Practice Address - Street 1:8017 JEFFERSON HWY
Practice Address - Street 2:STE A2
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70809
Practice Address - Country:US
Practice Address - Phone:225-405-7430
Practice Address - Fax:225-928-8485
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-07
Last Update Date:2020-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LALA7179225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist