Healthcare Provider Details

I. General information

NPI: 1922253970
Provider Name (Legal Business Name): HOLLY ANNE HOULAHAN LHAS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/18/2008
Last Update Date: 11/18/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

61 W AURORA RD
NORTHFIELD OH
44067-2003
US

IV. Provider business mailing address

61 W AURORA RD
NORTHFIELD OH
44067-2003
US

V. Phone/Fax

Practice location:
  • Phone: 330-467-4130
  • Fax: 330-467-4131
Mailing address:
  • Phone: 330-467-4130
  • Fax: 330-467-4131

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number2908
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: