Individual
TIERRA HOLMES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
686 STARK ST, LAWRENCEVILLE, GA 30046-4969
(414) 588-4339
Mailing address
686 STARK ST, LAWRENCEVILLE, GA 30046-4969
(414) 588-4339
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
5545
WI
225X00000X
Occupational Therapist
Primary
OT008096
GA
Other
Enumeration date
01/06/2016
Last updated
12/14/2023
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