Individual
MELISSA HOLMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCGC
Contact information
Practice address
615 N MICHIGAN ST, SOUTH BEND, IN 46601-1033
(574) 647-1100
(574) 647-5907
Mailing address
710 N NILES AVE, SOUTH BEND, IN 46617-1924
(574) 647-1610
(574) 237-6069
Taxonomy
Speciality
Code
Description
License number
State
170300000X
Genetic Counselor (M.S.)
Primary
99067670A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300009077
—
IN
Enumeration date
06/17/2015
Last updated
12/19/2017
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