Provider Demographics
NPI:1124742499
Name:HOLT, AMITY
Entity type:Individual
Prefix:
First Name:AMITY
Middle Name:
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 1:411 E KLUTZ ST
Mailing Address - Street 2:
Mailing Address - City:MAIDEN
Mailing Address - State:NC
Mailing Address - Zip Code:28650-1405
Mailing Address - Country:US
Mailing Address - Phone:828-514-2483
Mailing Address - Fax:
Practice Address - Street 1:6448 MAIN CIRCLE ST
Practice Address - Street 2:
Practice Address - City:CONNELLY SPRINGS
Practice Address - State:NC
Practice Address - Zip Code:28612-7506
Practice Address - Country:US
Practice Address - Phone:828-368-0729
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-30
Last Update Date:2022-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC30000781235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist