Provider Demographics
NPI:1225144322
Name:HOLT, RUTH N
Entity Type:Individual
Prefix:DR
First Name:RUTH
Middle Name:N
Last Name:HOLT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:72 NORTH ST
Mailing Address - Street 2:SUITE 201
Mailing Address - City:DANBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06810
Mailing Address - Country:US
Mailing Address - Phone:203-798-0068
Mailing Address - Fax:203-798-8859
Practice Address - Street 1:72 NORTH ST
Practice Address - Street 2:SUITE 201
Practice Address - City:DANBURY
Practice Address - State:CT
Practice Address - Zip Code:06810
Practice Address - Country:US
Practice Address - Phone:203-798-0068
Practice Address - Fax:203-798-8859
Is Sole Proprietor?:No
Enumeration Date:2006-08-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTLPC 000022101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT56240000022CT3OtherANTHEM BLUE CROSS
135064OtherVALUE OPTIONS
P3052491OtherOXFORD
213917OtherMHN