Provider Demographics
NPI:1346696051
Name:HOLMES, LANA (PSYD)
Entity Type:Individual
Prefix:DR
First Name:LANA
Middle Name:
Last Name:HOLMES
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:209B SWANTON WAY STE 204
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30030-3271
Mailing Address - Country:US
Mailing Address - Phone:678-561-4187
Mailing Address - Fax:
Practice Address - Street 1:209B SWANTON WAY STE 204
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30030-3271
Practice Address - Country:US
Practice Address - Phone:678-561-4187
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-11
Last Update Date:2021-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPSY004476103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical