Provider Demographics
NPI:1881796837
Name:HOLT, ROSE F (LPC)
Entity type:Individual
Prefix:MS
First Name:ROSE
Middle Name:F
Last Name:HOLT
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:905 BARNARD COLLEGE LN
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63130-2153
Mailing Address - Country:US
Mailing Address - Phone:314-726-2032
Mailing Address - Fax:314-726-0079
Practice Address - Street 1:905 BARNARD COLLEGE LN
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63130-2153
Practice Address - Country:US
Practice Address - Phone:314-726-2032
Practice Address - Fax:314-726-0079
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO002287101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional