Provider Demographics
NPI:1437682846
Name:HOLMES, KHADJA
Entity type:Individual
Prefix:
First Name:KHADJA
Middle Name:
Last Name:HOLMES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:KHADJA
Other - Middle Name:
Other - Last Name:WHITE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5041 DALLAS HWY STE 703
Mailing Address - Street 2:
Mailing Address - City:POWDER SPRINGS
Mailing Address - State:GA
Mailing Address - Zip Code:30127-6458
Mailing Address - Country:US
Mailing Address - Phone:404-913-6337
Mailing Address - Fax:404-393-7473
Practice Address - Street 1:5041 DALLAS HWY STE 703
Practice Address - Street 2:
Practice Address - City:POWDER SPRINGS
Practice Address - State:GA
Practice Address - Zip Code:30127-6458
Practice Address - Country:US
Practice Address - Phone:404-913-6337
Practice Address - Fax:404-393-7473
Is Sole Proprietor?:No
Enumeration Date:2017-04-04
Last Update Date:2025-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
No374U00000XNursing Service Related ProvidersHome Health Aide