Individual
MYA KIARA HOLT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
10309 CONGRESSIONAL CT, ELLICOTT CITY, MD 21042-2124
(410) 804-3587
Mailing address
10309 CONGRESSIONAL CT, ELLICOTT CITY, MD 21042-2124
(410) 804-3587
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
—
Other
Enumeration date
03/22/2022
Last updated
02/09/2023
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