Provider Demographics
NPI:1124856778
Name:HOLT, ASHLEY (CVT, CET)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:HOLT
Suffix:
Gender:F
Credentials:CVT, CET
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:244 MEMORIAL DR
Mailing Address - Street 2:B
Mailing Address - City:BARNESVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30204-1924
Mailing Address - Country:US
Mailing Address - Phone:404-596-0754
Mailing Address - Fax:
Practice Address - Street 1:244 MEMORIAL DR
Practice Address - Street 2:B
Practice Address - City:BARNESVILLE
Practice Address - State:GA
Practice Address - Zip Code:30204-1924
Practice Address - Country:US
Practice Address - Phone:404-596-0754
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-24
Last Update Date:2024-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
2472E0500X, 247200000X, 172A00000X
GAG6S6G9X9246W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246W00000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Cardiology
No2472E0500XTechnologists, Technicians & Other Technical Service ProvidersTechnician, OtherEEG
No247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other
No172A00000XOther Service ProvidersDriver