Individual
MS. BRENDA FAY HOLMES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS
Contact information
Practice address
2632 SW PORT ST LUCIE BLVD, PORT ST LUCIE, FL 34953-2845
(561) 616-8411
(561) 616-8412
Mailing address
2632 SW PORT ST LUCIE BLVD, PORT ST LUCIE, FL 34953-2845
(561) 616-8411
(561) 616-8412
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
171M00000X
Case Manager/Care Coordinator
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
596153749
—
FL
Enumeration date
08/30/2012
Last updated
11/26/2019
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