Individual
BRIAN W HOLT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
24 JOLIET ST, DYER, IN 46311-1705
(219) 322-5747
Mailing address
PO BOX 781076, DETROIT, MI 48278-1076
(317) 528-4800
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
34006627A
IN
1041C0700X
Clinical Social Worker
99052554A
IN
Other
Enumeration date
11/02/2012
Last updated
03/13/2021
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