Individual
JACQUELINE HOLMES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2733 WALSH LOOP SE, RIO RANCHO, NM 87124-2984
(505) 967-7509
Mailing address
2733 WALSH LOOP SE, RIO RANCHO, NM 87124-2984
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
3136
NM
Other
Enumeration date
01/15/2015
Last updated
01/15/2015
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