Provider Demographics
NPI:1669203881
Name:HOLMES, MELINDA ELIZABETH (STUDENT MSW)
Entity type:Individual
Prefix:
First Name:MELINDA
Middle Name:ELIZABETH
Last Name:HOLMES
Suffix:
Gender:F
Credentials:STUDENT MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8946 STATE ROUTE 19
Mailing Address - Street 2:
Mailing Address - City:CANEADEA
Mailing Address - State:NY
Mailing Address - Zip Code:14717-8709
Mailing Address - Country:US
Mailing Address - Phone:716-244-2121
Mailing Address - Fax:
Practice Address - Street 1:4222 BOLIVAR RD
Practice Address - Street 2:
Practice Address - City:WELLSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14895-9332
Practice Address - Country:US
Practice Address - Phone:585-593-1655
Practice Address - Fax:585-593-1868
Is Sole Proprietor?:No
Enumeration Date:2024-08-09
Last Update Date:2024-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health