Individual
NACOLE MARIETTA HOLMES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
831 12TH AVE, LONGVIEW, WA 98632-2403
(360) 998-2349
(360) 998-2887
Mailing address
1057 12TH AVE, LONGVIEW, WA 98632-2509
(360) 998-2349
(360) 998-2887
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
LW61544692
WA
101YM0800X
Mental Health Counselor
LW61544692
WA
104100000X
Social Worker
Primary
LW61544692
WA
Other
Enumeration date
06/08/2017
Last updated
10/31/2024
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