Provider Demographics
NPI:1316662687
Name:HOLMES, BRIANNA MEGAN
Entity type:Individual
Prefix:
First Name:BRIANNA
Middle Name:MEGAN
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 1:9794 WINCHESTER CIR S
Mailing Address - Street 2:
Mailing Address - City:SEMMES
Mailing Address - State:AL
Mailing Address - Zip Code:36575-8223
Mailing Address - Country:US
Mailing Address - Phone:251-744-4790
Mailing Address - Fax:
Practice Address - Street 1:2290 N RONALD REAGAN BLVD
Practice Address - Street 2:
Practice Address - City:LONGWOOD
Practice Address - State:FL
Practice Address - Zip Code:32750-3534
Practice Address - Country:US
Practice Address - Phone:407-215-0095
Practice Address - Fax:407-261-0523
Is Sole Proprietor?:No
Enumeration Date:2022-10-10
Last Update Date:2022-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)