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General NPI Number Information
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NPI Number | 1164966966
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Entity Type | Organization
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Legal Business Name | JESSICA HOLTON, PLLC
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Dates
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Enumeration Date | 12/13/2016
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Last Update Date | 10/26/2022
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Provider Practice Location Address
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Address Line | 740 GREENVILLE BLVD SE STE 400-208
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City | GREENVILLE
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State | NC
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Zip | 27858-5135
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Country | US
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Telephone | 252-987-3039
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Fax |
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Provider Business Mailing Address
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Address Line | 740 GREENVILLE BLVD SE STE 400-208
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City | GREENVILLE
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State | NC
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Zip | 27858-5135
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Country | US
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Telephone | 252-987-3039
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Fax |
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Authorized Official
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Title or Position | CLINICAL SOCIAL WORKER / PRESIDENT
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Name | JESSICA DENISE HOLTON
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Credential | MSW, LCSW, LCAS
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Telephone | 252-987-3039
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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