Provider Demographics
NPI:1740070820
Name:HOLDEN, JULIETTE (LRT-CTRS)
Entity type:Individual
Prefix:
First Name:JULIETTE
Middle Name:
Last Name:HOLDEN
Suffix:
Gender:F
Credentials:LRT-CTRS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4690 NW 30TH ST
Mailing Address - Street 2:
Mailing Address - City:COCONUT CREEK
Mailing Address - State:FL
Mailing Address - Zip Code:33063-5914
Mailing Address - Country:US
Mailing Address - Phone:919-667-6121
Mailing Address - Fax:
Practice Address - Street 1:4690 NW 30TH ST
Practice Address - Street 2:
Practice Address - City:COCONUT CREEK
Practice Address - State:FL
Practice Address - Zip Code:33063-5914
Practice Address - Country:US
Practice Address - Phone:919-667-6121
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-12
Last Update Date:2025-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1633225800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225800000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRecreation Therapist