Provider Demographics
NPI:1871200436
Name:HOLT, JULIA ANN (MS, CCC/SLP)
Entity type:Individual
Prefix:MRS
First Name:JULIA
Middle Name:ANN
Last Name:HOLT
Suffix:
Gender:F
Credentials:MS, CCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:114 KINGSTON CT
Mailing Address - Street 2:
Mailing Address - City:GRAY
Mailing Address - State:TN
Mailing Address - Zip Code:37615-3206
Mailing Address - Country:US
Mailing Address - Phone:423-502-7192
Mailing Address - Fax:
Practice Address - Street 1:2700 S ROAN ST STE 425
Practice Address - Street 2:
Practice Address - City:JOHNSON CITY
Practice Address - State:TN
Practice Address - Zip Code:37601-7587
Practice Address - Country:US
Practice Address - Phone:423-502-7192
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-03
Last Update Date:2022-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000001469235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist