Provider Demographics
NPI:1780709378
Name:HOLT, SUSAN PEARRE (MS CCC SLP)
Entity type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:PEARRE
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 1:1111 CHEROKEE DR
Mailing Address - Street 2:
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28739-5513
Mailing Address - Country:US
Mailing Address - Phone:828-693-3406
Mailing Address - Fax:
Practice Address - Street 1:852 MERRIMON AVE
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28804-2405
Practice Address - Country:US
Practice Address - Phone:828-694-7979
Practice Address - Fax:828-694-7980
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC6516235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
01089253OtherASHA
NC139J2OtherBCBS