MEDICARE: HOLLY ANN PARR MA/CCC-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	8620	MN

General Provider Information

NPI Number	:	1134449002
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HOLLY ANN PARR MA/CCC-SLP

Provider Business Mailing Address
First Line	:	3009 WALNUT GROVE LN N
Second Line	:
City	:	PLYMOUTH
State	:	MN
Zip	:	55447-1568
Country	:	US
Telephone Number	:	612-298-2984
Fax Number	:

Provider Business Practice Location Address
First Line	:	3009 WALNUT GROVE LN N
Second Line	:
City	:	PLYMOUTH
State	:	MN
Zip	:	55447-1568
Country	:	US
Telephone Number	:	612-298-2984
Fax Number	:

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

Provider Enumeration Date	:	06/02/2010
Last Update Date	:	07/18/2022

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Directions to “ HOLLY ANN PARR MA/CCC-SLP” Practice Location

Language	Start Address	Practice Location

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