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Individual

ERIC HOLMES

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
1705 CRADDUCK RD, ADA, OK 74820-9491
(580) 310-9000
Mailing address
3622 GOVERNOR HARRIS DR, ADA, OK 74820-9258
(918) 312-0450

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
J081056657
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100744520B
OK
05
100744520D
OK
Enumeration date
04/23/2013
Last updated
11/21/2013
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