Provider Demographics
NPI:1790405355
Name:HOLT, MARYANN LENA (LMFT)
Entity Type:Individual
Prefix:MS
First Name:MARYANN
Middle Name:LENA
Last Name:HOLT
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 CIRCLE OF HOLLY
Mailing Address - Street 2:
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79605-4917
Mailing Address - Country:US
Mailing Address - Phone:325-268-1053
Mailing Address - Fax:
Practice Address - Street 1:1017 BUTTERNUT ST
Practice Address - Street 2:
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79602-2523
Practice Address - Country:US
Practice Address - Phone:325-268-1053
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-01
Last Update Date:2023-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX203798101YM0800X, 106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health