MEDICARE: KASEE NOEL HOLM 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	SZ6129	FL

General Provider Information

NPI Number	:	1972841062
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KASEE NOEL HOLM SLP

Provider Business Mailing Address
First Line	:	13538 VILLAGE PARK DR
Second Line	:	215
City	:	ORLANDO
State	:	FL
Zip	:	32837-7698
Country	:	US
Telephone Number	:	321-872-7157
Fax Number	:	407-730-2948

Provider Business Practice Location Address
First Line	:	13538 VILLAGE PARK DR
Second Line	:	215
City	:	ORLANDO
State	:	FL
Zip	:	32837-7698
Country	:	US
Telephone Number	:	321-872-7157
Fax Number	:	407-730-2948

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

Provider Enumeration Date	:	01/23/2013
Last Update Date	:	01/23/2013

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Directions to “ KASEE NOEL HOLM SLP” Practice Location

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