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NPI Code Detail

MEDICARE: MRS. ASHLEY HOLLIS BA

MEDICARE: MRS. ASHLEY HOLLIS BA
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
12355S0801XSpeech-Language Assistant37256TX

General Provider Information

NPI Number : 1538683172
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. ASHLEY HOLLIS BA
Provider Business Mailing Address
First Line : 440 HIGHWAY 59 LOOP S STE 104
Second Line :
City : LIVINGSTON
State : TX
Zip : 77351-9011
Country : US
Telephone Number : 936-328-8148
Fax Number :
Provider Business Practice Location Address
First Line : 440 HIGHWAY 59 LOOP S STE 104
Second Line :
City : LIVINGSTON
State : TX
Zip : 77351-9011
Country : US
Telephone Number : 936-328-8148
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/26/2017
Last Update Date : 07/26/2017

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Directions to “ MRS. ASHLEY HOLLIS BA” Practice Location

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