Provider Demographics
NPI:1669276176
Name:HOLMES, JEFFREY CHRISTOPHER II
Entity type:Individual
Prefix:
First Name:JEFFREY
Middle Name:CHRISTOPHER
Last Name:HOLMES
Suffix:II
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35 WALPOLE ST STE 207
Mailing Address - Street 2:
Mailing Address - City:STAFFORD
Mailing Address - State:VA
Mailing Address - Zip Code:22554-6546
Mailing Address - Country:US
Mailing Address - Phone:540-383-7133
Mailing Address - Fax:
Practice Address - Street 1:35 WALPOLE ST STE 207
Practice Address - Street 2:
Practice Address - City:STAFFORD
Practice Address - State:VA
Practice Address - Zip Code:22554-6546
Practice Address - Country:US
Practice Address - Phone:540-383-7133
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-03
Last Update Date:2025-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician