MEDICARE: MRS. ANNE-MARIE S HOLLIS SLP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	4545	TN

General Provider Information

NPI Number	:	1033789797
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ANNE-MARIE S HOLLIS SLP

Provider Business Mailing Address
First Line	:	363 OAK CHASE LN
Second Line	:
City	:	WAVERLY
State	:	TN
Zip	:	37185-2943
Country	:	US
Telephone Number	:	161-535-1744
Fax Number	:

Provider Business Practice Location Address
First Line	:	77 E LAKE ST
Second Line	:
City	:	CAMDEN
State	:	TN
Zip	:	38320-2019
Country	:	US
Telephone Number	:	731-584-0942
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/25/2021
Last Update Date	:	09/28/2021

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Directions to “ MRS. ANNE-MARIE S HOLLIS SLP” Practice Location

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