Provider Demographics
NPI:1205509866
Name:HOLMES, TANIAH
Entity type:Individual
Prefix:
First Name:TANIAH
Middle Name:
Last Name:HOLMES
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 1:5620 SAINT BARNABAS RD STE 360
Mailing Address - Street 2:
Mailing Address - City:OXON HILL
Mailing Address - State:MD
Mailing Address - Zip Code:20745-3628
Mailing Address - Country:US
Mailing Address - Phone:240-766-4552
Mailing Address - Fax:240-766-4502
Practice Address - Street 1:5620 SAINT BARNABAS RD STE 360
Practice Address - Street 2:
Practice Address - City:OXON HILL
Practice Address - State:MD
Practice Address - Zip Code:20745-3628
Practice Address - Country:US
Practice Address - Phone:240-766-4552
Practice Address - Fax:240-766-4502
Is Sole Proprietor?:No
Enumeration Date:2021-07-29
Last Update Date:2021-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator