Provider Demographics
NPI:1932658796
Name:HOLT, ERICA LYNNETTE
Entity Type:Individual
Prefix:MRS
First Name:ERICA
Middle Name:LYNNETTE
Last Name:HOLT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2080 WHITTAKER RD
Mailing Address - Street 2:STE 138
Mailing Address - City:YPSILANTI
Mailing Address - State:MI
Mailing Address - Zip Code:48197-8238
Mailing Address - Country:US
Mailing Address - Phone:734-448-2265
Mailing Address - Fax:
Practice Address - Street 1:6593 SUMMERDALE CIR W
Practice Address - Street 2:
Practice Address - City:YPSILANTI
Practice Address - State:MI
Practice Address - Zip Code:48197-6145
Practice Address - Country:US
Practice Address - Phone:734-448-2265
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-22
Last Update Date:2016-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator