Individual
RYAN EDWARD HOLT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
1723 E SOUTHLAKE BLVD STE 200, SOUTHLAKE, TX 76092-6445
(682) 292-7012
Mailing address
16173 FAIRVIEW AVE, FONTANA, CA 92336-2485
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
32870
CA
103T00000X
Psychologist
Primary
38271
TX
Other
Enumeration date
03/21/2022
Last updated
03/21/2022
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