Provider Demographics
NPI:1225552490
Name:HOLT, SHNATTA
Entity Type:Individual
Prefix:
First Name:SHNATTA
Middle Name:
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:PO BOX 1902
Mailing Address - Street 2:
Mailing Address - City:DARLINGTON
Mailing Address - State:SC
Mailing Address - Zip Code:29540-1902
Mailing Address - Country:US
Mailing Address - Phone:843-309-6259
Mailing Address - Fax:
Practice Address - Street 1:1780 TIMMONSVILLE HWY
Practice Address - Street 2:
Practice Address - City:DARLINGTON
Practice Address - State:SC
Practice Address - Zip Code:29532-7501
Practice Address - Country:US
Practice Address - Phone:843-309-6259
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-31
Last Update Date:2017-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management