Provider Demographics
NPI:1346810033
Name:HOLCOMB, DENISE
Entity Type:Individual
Prefix:MISS
First Name:DENISE
Middle Name:
Last Name:HOLCOMB
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 21362
Mailing Address - Street 2:
Mailing Address - City:SOUTH EUCLID
Mailing Address - State:OH
Mailing Address - Zip Code:44121-0362
Mailing Address - Country:US
Mailing Address - Phone:833-784-4622
Mailing Address - Fax:833-784-4622
Practice Address - Street 1:14172 CEDAR RD APT 205
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44121-3228
Practice Address - Country:US
Practice Address - Phone:833-784-4622
Practice Address - Fax:833-784-4622
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-25
Last Update Date:2021-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH0001993175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist