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NPI Code Detail

MEDICARE: CRYSTAL HOLT CASE MANAGER

MEDICARE: CRYSTAL HOLT CASE MANAGER
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
1101Y00000XCounselor

General Provider Information

NPI Number : 1962465773
Entity Type Code : Individual
Provider Name (Legal Business Name) : CRYSTAL HOLT CASE MANAGER
Provider Business Mailing Address
First Line : 201 W SPRINGDALE AVE
Second Line :
City : KNOXVILLE
State : TN
Zip : 37917-5158
Country : US
Telephone Number : 865-637-9711
Fax Number : 865-637-4362
Provider Business Practice Location Address
First Line : 201 W SPRINGDALE AVE
Second Line :
City : KNOXVILLE
State : TN
Zip : 37917-5158
Country : US
Telephone Number : 865-637-9711
Fax Number : 865-637-4362
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/11/2006
Last Update Date : 07/08/2007

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