Individual
EDNA FAYE HOLMES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5808 DEVERS DR, H, INDIANAPOLIS, IN 46216-2137
(317) 918-1921
Mailing address
5808 DEVERS DR, H, INDIANAPOLIS, IN 46216-2137
(317) 918-1921
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100270530
—
IN
Enumeration date
10/06/2006
Last updated
08/18/2014
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