Individual
TINA MARIE HOLMES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRSW
Contact information
Practice address
123 MAIN ST, GORHAM, NH 03581-1659
(603) 466-5190
Mailing address
123 MAIN ST, GORHAM, NH 03581-1659
(603) 752-2511
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
0241
NH
Other
Enumeration date
01/09/2020
Last updated
01/09/2020
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