Provider Demographics
NPI:1306345053
Name:HOLMES, TA-KENDA EMPRESS
Entity type:Individual
Prefix:
First Name:TA-KENDA
Middle Name:EMPRESS
Last Name:HOLMES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1950 RAMBLING DR SW UNIT 720
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30315-5968
Mailing Address - Country:US
Mailing Address - Phone:510-967-2230
Mailing Address - Fax:
Practice Address - Street 1:1950 RAMBLING DR SW UNIT 720
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30315-5968
Practice Address - Country:US
Practice Address - Phone:510-967-2230
Practice Address - Fax:510-967-2230
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-08
Last Update Date:2018-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health