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General NPI Number Information
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NPI Number | 1689248858
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Entity Type | Individual
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Provider Name | MRS. SHAKUANDA U. HOLT
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Gender | Female
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Dates
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Enumeration Date | 05/13/2021
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Last Update Date | 05/13/2021
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Provider Practice Location Address
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Address Line | 18425 NW 2ND AVE PH 5
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City | MIAMI GARDENS
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State | FL
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Zip | 33169-4524
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Country | US
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Telephone | 954-257-7473
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Fax |
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Provider Business Mailing Address
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Address Line | 1815 NATCHEZ TRACE BLVD
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City | ORLANDO
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State | FL
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Zip | 32818-9042
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Country | US
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Telephone | 786-355-3781
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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 | 103TS0200X
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Taxonomy Name | School Psychologist
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License Number | SS1568
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License Number State | FL
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