Individual
PATRICE JANELL HOLMES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
103 S MAIN ST, CENTER FOR BEHAVIORAL HEALTH OUTPATIENT, MIDDLETOWN, CT 06457-3651
(860) 358-8760
Mailing address
103 S MAIN ST, CENTER FOR BEHAVIORAL HEALTH OUTPATIENT, MIDDLETOWN, CT 06457-3651
(860) 358-8760
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
MTL000406
DC
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
1.053250
CT
208600000X
Surgery Physician
LL32908
SC
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/28/2010
Last updated
08/25/2016
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