Provider Demographics
NPI:1154127066
Name:HOLDEN, JAYNE (NBC-HWC)
Entity type:Individual
Prefix:
First Name:JAYNE
Middle Name:
Last Name:HOLDEN
Suffix:
Gender:
Credentials:NBC-HWC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22575 LEANNE TER APT 429
Mailing Address - Street 2:
Mailing Address - City:ASHBURN
Mailing Address - State:VA
Mailing Address - Zip Code:20148-6857
Mailing Address - Country:US
Mailing Address - Phone:843-817-7518
Mailing Address - Fax:
Practice Address - Street 1:22575 LEANNE TER APT 429
Practice Address - Street 2:
Practice Address - City:ASHBURN
Practice Address - State:VA
Practice Address - Zip Code:20148-6857
Practice Address - Country:US
Practice Address - Phone:843-817-7518
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-21
Last Update Date:2025-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
A-3197960171400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach