Individual
BRENT LAMAR HOLT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
6701 MADISON AVE, CLEVELAND, OH 44102-4035
(216) 609-6259
Mailing address
6701 MADISON AVE, CLEVELAND, OH 44102-4035
(216) 609-6259
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
21441664
OH
Other
Enumeration date
08/21/2018
Last updated
08/21/2018
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