MEDICARE: CIMONE HOLT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	175T00000X	Peer Specialist		GA

General Provider Information

NPI Number	:	1871456368
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CIMONE HOLT

Provider Business Mailing Address
First Line	:	10103 ASHFORD GABLES DR
Second Line	:
City	:	DUNWOODY
State	:	GA
Zip	:	30338-7837
Country	:	US
Telephone Number	:	678-646-8446
Fax Number	:

Provider Business Practice Location Address
First Line	:	8735 DUNWOODY PL STE R
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30350-2995
Country	:	US
Telephone Number	:	678-646-8446
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/03/2025
Last Update Date	:	12/03/2025

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Directions to “ CIMONE HOLT ” Practice Location

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