Provider Demographics
NPI:1245782846
Name:HOLT, SARAH (MS, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:
Last Name:HOLT
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:303 WYLY DR
Mailing Address - Street 2:
Mailing Address - City:LAKE PROVIDENCE
Mailing Address - State:LA
Mailing Address - Zip Code:71254-5359
Mailing Address - Country:US
Mailing Address - Phone:318-282-9013
Mailing Address - Fax:
Practice Address - Street 1:303 WYLY DR
Practice Address - Street 2:
Practice Address - City:LAKE PROVIDENCE
Practice Address - State:LA
Practice Address - Zip Code:71254-5359
Practice Address - Country:US
Practice Address - Phone:318-282-9013
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-30
Last Update Date:2016-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA7396235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist