Provider Demographics
NPI:1801168299
Name:CHRISTI HOLT MA CCC SLP
Entity type:Organization
Organization Name:CHRISTI HOLT MA CCC SLP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:WINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:GRAY
Authorized Official - Suffix:
Authorized Official - Credentials:CPC
Authorized Official - Phone:318-381-8520
Mailing Address - Street 1:205 CIRCLE DR
Mailing Address - Street 2:
Mailing Address - City:WEST MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71291-5305
Mailing Address - Country:US
Mailing Address - Phone:318-381-8520
Mailing Address - Fax:888-616-5693
Practice Address - Street 1:810 N 29TH ST
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:LA
Practice Address - Zip Code:71201-3704
Practice Address - Country:US
Practice Address - Phone:318-600-4260
Practice Address - Fax:318-600-4268
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-01
Last Update Date:2020-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty