Provider Demographics
NPI:1558583831
Name:HOLMES, MARLENE ROSE (ASSOHUMAN SERVICES)
Entity Type:Individual
Prefix:MISS
First Name:MARLENE
Middle Name:ROSE
Last Name:HOLMES
Suffix:
Gender:F
Credentials:ASSOHUMAN SERVICES
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 1071
Mailing Address - Street 2:
Mailing Address - City:PIKEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27863-1071
Mailing Address - Country:US
Mailing Address - Phone:919-394-0761
Mailing Address - Fax:
Practice Address - Street 1:3423 A MELROSE ROAD
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28304
Practice Address - Country:US
Practice Address - Phone:910-864-8739
Practice Address - Fax:910-864-8222
Is Sole Proprietor?:No
Enumeration Date:2007-05-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)