Individual
KIANTE HOLMES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
11936 NE SANDY BLVD, PORTLAND, OR 97220-1450
(503) 206-7864
Mailing address
19814 NE HASSALO CT, PORTLAND, OR 97230-7969
(503) 997-2659
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
1041C0700X
Clinical Social Worker
Primary
A4682
OR
1041S0200X
School Social Worker
545074
OR
Other
Enumeration date
08/12/2013
Last updated
07/30/2021
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