NPI 1477090041

Shelley Holt

Practitioner Prevention Professional San Bernardino, CA

Practice location

Address: 17573 Chervil Ln, San Bernardino, CA 92407-9068
Phone: (909) 544-6482

Registered specialties

Prevention Professional Primary

Other Service Providers Taxonomy 405300000X Licence 0000000 (CA)

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Registry record

NPI: 1477090041
Entity type: Individual
Sex (as registered): Female
NPI issued: 20 Jan 2017
Record last updated: 20 Jan 2017

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.