Provider Demographics
NPI:1902199458
Name:HOLCOMB, AARON J
Entity Type:Individual
Prefix:
First Name:AARON
Middle Name:J
Last Name:HOLCOMB
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:255 W MOANA LN STE 104
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89509-4942
Mailing Address - Country:US
Mailing Address - Phone:775-525-0270
Mailing Address - Fax:
Practice Address - Street 1:255 W MOANA LN STE 104
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89509-4942
Practice Address - Country:US
Practice Address - Phone:775-525-0270
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-17
Last Update Date:2015-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children