Individual
MR. LYLE ALLEN HOLTHUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
SCHOOL PSYCHOLOGIST
Contact information
Practice address
2840 NW 2ND AVE STE 104, BOCA RATON, FL 33431-6692
(800) 233-5976
(800) 238-3365
Mailing address
2840 NW 2ND AVE STE 104, BOCA RATON, FL 33431-6692
(800) 233-5976
(800) 238-3365
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
1525226142
KS
Other
Enumeration date
07/30/2018
Last updated
07/30/2018
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