Provider Demographics
NPI:1235479759
Name:HOLTZ, PAMELA ROSE (MED)
Entity Type:Individual
Prefix:MS
First Name:PAMELA
Middle Name:ROSE
Last Name:HOLTZ
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4280 HALE PKWY
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80220-3724
Mailing Address - Country:US
Mailing Address - Phone:303-322-1871
Mailing Address - Fax:303-399-3411
Practice Address - Street 1:4280 HALE PKWY
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80220-3724
Practice Address - Country:US
Practice Address - Phone:303-322-1871
Practice Address - Fax:303-399-3411
Is Sole Proprietor?:No
Enumeration Date:2013-02-20
Last Update Date:2013-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0416574235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist