Doctor Name: | ALICIA HOLLEY |
NPI Number: | 1225245459 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 0392 |
Business Practice Address: | 206 Maryland Ave Mccomb, MS - 396483926 |
Business Phone Number: | 6012504815 |
Business Fax Number: | 6012506859 |
Mailing Address: | 4857 Goodman Rd, Suite 107 OLIVE BRANCH |
State: | MS |
Postal Code: | 386547914 |
Phone Number: | 6012504815 |
Fax Number: | 6012506859 |
NPI Enumeration Date: | 05/17/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 0392 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MS |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Speech-Language Pathologist |
Taxonomy Specialization: | |
Taxonomy Definition: | A speech pathologist is a person qualified by a master |