Provider Demographics
NPI:1457695868
Name:HOLT, ANJENEAN (MS CCC/SLP)
Entity Type:Individual
Prefix:MRS
First Name:ANJENEAN
Middle Name:
Last Name: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 1:150 W. LAUREL RIVER DR.
Mailing Address - Street 2:
Mailing Address - City:SHEPHERDSVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40165
Mailing Address - Country:US
Mailing Address - Phone:502-543-1020
Mailing Address - Fax:
Practice Address - Street 1:310 BOXWOOD RUN RD
Practice Address - Street 2:
Practice Address - City:MT. WASHINGTON
Practice Address - State:KY
Practice Address - Zip Code:40047
Practice Address - Country:US
Practice Address - Phone:502-538-3500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-26
Last Update Date:2012-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYKY-2774235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist