Healthcare Provider Details

I. General information

NPI: 1952242752
Provider Name (Legal Business Name): CHRISTOPHER EDWARD HOLT CCC-SLP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/03/2026
Last Update Date: 04/03/2026
Certification Date: 04/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

325 W PASADENA AVE APT 16
PHOENIX AZ
85013-2339
US

IV. Provider business mailing address

325 W PASADENA AVE APT 16
PHOENIX AZ
85013-2339
US

V. Phone/Fax

Practice location:
  • Phone: 919-302-3493
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSLP17199
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: