Healthcare Provider Details

I. General information

NPI: 1124944079
Provider Name (Legal Business Name): JINIDA ASHLEY HOLT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/25/2026
Last Update Date: 06/25/2026
Certification Date: 06/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9064 HELENA RD
PELHAM AL
35124-2737
US

IV. Provider business mailing address

984 MERIWEATHER DR
CALERA AL
35040-6242
US

V. Phone/Fax

Practice location:
  • Phone: 205-644-1166
  • Fax:
Mailing address:
  • Phone: 205-420-9625
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number7067G
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: