Doctor Name: | BRADLEY R HOLT |
NPI Number: | 1578997060 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MA, MBA |
License Number: | |
Business Practice Address: | 175 King Of Prussia Rd Radnor, PA - 190874521 |
Business Phone Number: | 6106446464 |
Business Fax Number: | 6109816078 |
Mailing Address: | 680 American Ave, Suite 302 KING OF PRUSSIA |
State: | PA |
Postal Code: | 194064023 |
Phone Number: | 6106446464 |
Fax Number: | 6109816078 |
NPI Enumeration Date: | 09/03/2013 |
NPI Last Update Date: | 02/23/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YA0400X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Addiction (Substance Use Disorder) |
Taxonomy Definition: |