Provider Demographics
NPI:1154052405
Name:HOLDER, LATOYA TERRY (LCDC, CAMS-I)
Entity Type:Individual
Prefix:
First Name:LATOYA
Middle Name:TERRY
Last Name:HOLDER
Suffix:
Gender:F
Credentials:LCDC, CAMS-I
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7601 FM 1960 RD E # 338
Mailing Address - Street 2:
Mailing Address - City:HUMBLE
Mailing Address - State:TX
Mailing Address - Zip Code:77346-2209
Mailing Address - Country:US
Mailing Address - Phone:281-549-0230
Mailing Address - Fax:
Practice Address - Street 1:1803 SUN POINT CT
Practice Address - Street 2:
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77396-3171
Practice Address - Country:US
Practice Address - Phone:281-549-0230
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-17
Last Update Date:2022-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX13082101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)