Provider Demographics
NPI:1639696917
Name:HOLT, ELIZABETH LEPPALUOTO (MFT)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:LEPPALUOTO
Last Name:HOLT
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1054 HENLEY DOWNS PL
Mailing Address - Street 2:
Mailing Address - City:LAKE MARY
Mailing Address - State:FL
Mailing Address - Zip Code:32746-1972
Mailing Address - Country:US
Mailing Address - Phone:407-782-8833
Mailing Address - Fax:
Practice Address - Street 1:1054 HENLEY DOWNS PL
Practice Address - Street 2:
Practice Address - City:LAKE MARY
Practice Address - State:FL
Practice Address - Zip Code:32746-1972
Practice Address - Country:US
Practice Address - Phone:407-782-8833
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-28
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL3307106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist