Provider Demographics
NPI:1689391518
Name:HOLMAN, JANET KAY
Entity Type:Individual
Prefix:
First Name:JANET
Middle Name:KAY
Last Name:HOLMAN
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 1:11563 BACK MASSILLON RD LOT 59
Mailing Address - Street 2:
Mailing Address - City:ORRVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44667-9781
Mailing Address - Country:US
Mailing Address - Phone:330-749-2778
Mailing Address - Fax:
Practice Address - Street 1:1715 MECHANICSBURG RD
Practice Address - Street 2:
Practice Address - City:WOOSTER
Practice Address - State:OH
Practice Address - Zip Code:44691-2640
Practice Address - Country:US
Practice Address - Phone:330-641-8837
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-21
Last Update Date:2022-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TH0004XBehavioral Health & Social Service ProvidersPsychologistHealth
No103TH0100XBehavioral Health & Social Service ProvidersPsychologistHealth Service