Individual
MS. IDA A HOLT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP-BC
Contact information
Practice address
8268 164TH ST, JAMAICA, NY 11432-1121
(718) 883-4027
Mailing address
8268 164TH ST, JAMAICA, NY 11432-1121
(718) 883-4027
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
404454
NY
Other
Enumeration date
12/13/2022
Last updated
12/13/2022
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