Holt, Brent Marion

Holt, Brent Marion is an individual health care provider with primary practice located at 1010 E 10Th St , Tucson AZ 85719-5813. He recently has only one registered license in Behavioral Health & Social Service Providers / School, which is considered as his primary health care specialty. Holt, Brent Marion can be contacted via phone (520) 225-6410.

Contact Information

Primary practice address
1010 E 10Th St Tucson AZ 85719-5813
Phone: (520) 225-6410
Fax: (520) 225-6170
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / School 103TS0200X Arizona

Profile Details

NPI number 1780809475
LBN Legal business name Holt, Brent Marion
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 16th, 2007
Last updated Jul 26th, 2007 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1780809475 NPPES
Arizona MEDICAID 595598

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