Provider Demographics
NPI:1780032789
Name:LOVE HOLT, CIERRA NICOLE (MS, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:CIERRA
Middle Name:NICOLE
Last Name:LOVE 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 1:6810 GOLD KINGS CIR UNIT C
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99504-1196
Mailing Address - Country:US
Mailing Address - Phone:706-910-8157
Mailing Address - Fax:
Practice Address - Street 1:6810 GOLD KINGS CIR UNIT C
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99504-1196
Practice Address - Country:US
Practice Address - Phone:706-910-8157
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-31
Last Update Date:2016-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPCET002129235Z00000X
AK548235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist