Provider Demographics
NPI:1831661065
Name:HOLMES, SHARLENE NATASHA (CPED)
Entity Type:Individual
Prefix:
First Name:SHARLENE
Middle Name:NATASHA
Last Name:HOLMES
Suffix:
Gender:F
Credentials:CPED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:733 FREDERICK RD
Mailing Address - Street 2:
Mailing Address - City:CATONSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21228-4503
Mailing Address - Country:US
Mailing Address - Phone:410-719-1222
Mailing Address - Fax:410-247-9110
Practice Address - Street 1:1307 FRANCIS AVE
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21227-3913
Practice Address - Country:US
Practice Address - Phone:410-247-3344
Practice Address - Fax:410-247-9110
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-28
Last Update Date:2022-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes224L00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPedorthistGroup - Single Specialty