Provider Demographics
NPI:1588830301
Name:HOLT, NANETTE MARIE (MC LPC)
Entity Type:Individual
Prefix:MS
First Name:NANETTE
Middle Name:MARIE
Last Name:HOLT
Suffix:
Gender:F
Credentials:MC LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4501 NO 22ND ST
Mailing Address - Street 2:SUITE 290
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85016
Mailing Address - Country:US
Mailing Address - Phone:602-952-1740
Mailing Address - Fax:602-224-4131
Practice Address - Street 1:4501 NO 22ND ST
Practice Address - Street 2:SUITE 290
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85016
Practice Address - Country:US
Practice Address - Phone:602-952-1740
Practice Address - Fax:602-224-4131
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-01
Last Update Date:2008-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPC0882101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional