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General NPI Number Information
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NPI Number | 1730416454
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Entity Type | Individual
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Provider Name | BETH MARIE HOLT LMFT
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Gender | Female
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Dates
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Enumeration Date | 11/17/2009
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Last Update Date | 01/15/2025
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Provider Practice Location Address
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Address Line | 4346 W ROSE HILL ST
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City | BOISE
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State | ID
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Zip | 83705-5193
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Country | US
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Telephone | 208-789-6209
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Fax |
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Provider Business Mailing Address
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Address Line | 4750 N FIVE MILE RD
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City | BOISE
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State | ID
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Zip | 83713-2715
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Country | US
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Telephone | 516-220-9410
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 000767
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 6927
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License Number State | ID
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