Individual
WILLIAM HOLT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
1771 CENTENNIAL DR, LARAMIE, WY 82070-8403
(307) 742-3571
Mailing address
109 OLD WAGON RD, TIE SIDING, WY 82084-3029
(940) 594-1115
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
LPC-1246
WY
101Y00000X
Counselor
PPC-546
WY
101YP2500X
Professional Counselor
Primary
LPC - 1246
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
546
STATE LICENSE
WY
01
—
LPC - 1246
STATE
WY
Enumeration date
09/29/2011
Last updated
05/03/2017
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