Healthcare Provider Details

I. General information

NPI: 1083832356
Provider Name (Legal Business Name): HOLLINS COMMUNICATIONS RESEARCH INSTITUTE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/23/2007
Last Update Date: 06/21/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7851 ENON DR
ROANOKE VA
24019-1515
US

IV. Provider business mailing address

7851 ENON DRIVE
ROANOKE VA
24019
US

V. Phone/Fax

Practice location:
  • Phone: 540-265-5650
  • Fax: 540-265-0386
Mailing address:
  • Phone: 540-265-5650
  • Fax: 540-265-0386

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number0701004697
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number01414887
License Number StateVA
# 3
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number01414887
License Number StateVA
# 4
Primary TaxonomyN
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number01414887
License Number StateVA

VIII. Authorized Official

Name: DR. RONALD L WEBSTER
Title or Position: PRESIDENT
Credential: PH.D.
Phone: 540-265-5650