Healthcare Provider Details

I. General information

NPI: 1134476716
Provider Name (Legal Business Name): MRS. HOLLY ANN HEMMERLEIN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/13/2012
Last Update Date: 08/13/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1178 N MAIN ST
FRANKLIN IN
46131-1251
US

IV. Provider business mailing address

3709 S CRAMER CIR
BLOOMINGTON IN
47403-8845
US

V. Phone/Fax

Practice location:
  • Phone: 812-343-2797
  • Fax:
Mailing address:
  • Phone: 765-729-4573
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: