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NPI Code Detail

MEDICARE: ANDREA LEIGH HOLT LMFT

MEDICARE:   ANDREA LEIGH HOLT  LMFT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YA0400XAddiction (Substance Use Disorder) Counselor6684CO
2106H00000XMarriage & Family Therapist763CO

General Provider Information

NPI Number : 1750600342
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANDREA LEIGH HOLT LMFT
Provider Business Mailing Address
First Line : 612 S COLLEGE AVE
Second Line : SUITE 23
City : FORT COLLINS
State : CO
Zip : 80524-3071
Country : US
Telephone Number : 970-691-9007
Fax Number :
Provider Business Practice Location Address
First Line : 612 S COLLEGE AVE
Second Line : SUITE 23
City : FORT COLLINS
State : CO
Zip : 80524-3071
Country : US
Telephone Number : 970-691-9007
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/23/2010
Last Update Date : 12/03/2011

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Directions to “ ANDREA LEIGH HOLT LMFT” Practice Location

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