Provider Demographics
NPI:1013384080
Name:HOLT, ABIGAIL V
Entity type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:V
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 1:469 BLACK ROCK TPKE
Mailing Address - Street 2:
Mailing Address - City:REDDING
Mailing Address - State:CT
Mailing Address - Zip Code:06896-1628
Mailing Address - Country:US
Mailing Address - Phone:203-939-5788
Mailing Address - Fax:
Practice Address - Street 1:469 BLACK ROCK TPKE
Practice Address - Street 2:
Practice Address - City:REDDING
Practice Address - State:CT
Practice Address - Zip Code:06896-1628
Practice Address - Country:US
Practice Address - Phone:203-939-5788
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-26
Last Update Date:2025-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1-14-16414103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst