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General NPI Number Information
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NPI Number | 1376090126
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Entity Type | Individual
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Provider Name | CAROL HOLT
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Gender | Female
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Dates
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Enumeration Date | 09/08/2016
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Last Update Date | 09/08/2016
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Provider Practice Location Address
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Address Line | 2702 CLAYTON RD
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City | CONCORD
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State | CA
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Zip | 94519-2789
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Country | US
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Telephone | 925-798-9240
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Fax |
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Provider Business Mailing Address
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Address Line | 1224 PINE ST UNIT B
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City | MARTINEZ
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State | CA
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Zip | 94553-1705
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Country | US
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Telephone | 925-822-6887
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | IMF85696
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License Number State | CA
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