Provider Demographics
NPI:1538441886
Name:HOLMES, MIHAELA (QMHP)
Entity type:Individual
Prefix:
First Name:MIHAELA
Middle Name:
Last Name:HOLMES
Suffix:
Gender:F
Credentials:QMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4150 S HUALAPAI WAY UNIT 2089
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89147-8767
Mailing Address - Country:US
Mailing Address - Phone:702-426-0710
Mailing Address - Fax:
Practice Address - Street 1:4150 S HUALAPAI WAY UNIT 2089
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89147-8767
Practice Address - Country:US
Practice Address - Phone:702-426-0710
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-13
Last Update Date:2023-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225400000X
NV9106-M1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner