Provider Demographics
NPI:1407973787
Name:DALMASI, HOLVA MURAIMA
Entity Type:Individual
Prefix:MS
First Name:HOLVA
Middle Name:MURAIMA
Last Name:DALMASI
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 1:34 BAYLIS ST SW
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49507-2939
Mailing Address - Country:US
Mailing Address - Phone:718-207-2717
Mailing Address - Fax:
Practice Address - Street 1:17160 130TH AVE
Practice Address - Street 2:
Practice Address - City:NUNICA
Practice Address - State:MI
Practice Address - Zip Code:49448-9450
Practice Address - Country:US
Practice Address - Phone:616-847-4460
Practice Address - Fax:616-847-4467
Is Sole Proprietor?:No
Enumeration Date:2007-03-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator