Provider Demographics
NPI:1013260959
Name:HOLMES, DAWN M (MS, RD, CSSD, LD)
Entity Type:Individual
Prefix:MRS
First Name:DAWN
Middle Name:M
Last Name:HOLMES
Suffix:
Gender:F
Credentials:MS, RD, CSSD, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:906 PLEASANT RIDGE AVE
Mailing Address - Street 2:
Mailing Address - City:BEXLEY
Mailing Address - State:OH
Mailing Address - Zip Code:43209-2430
Mailing Address - Country:US
Mailing Address - Phone:614-441-6872
Mailing Address - Fax:
Practice Address - Street 1:3705 OLENTANGY RIVER RD
Practice Address - Street 2:SUITE 260
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43214-3467
Practice Address - Country:US
Practice Address - Phone:614-566-2786
Practice Address - Fax:614-533-6609
Is Sole Proprietor?:No
Enumeration Date:2012-10-16
Last Update Date:2017-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH6159133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered