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General NPI Number Information
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NPI Number | 1104219237
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Entity Type | Individual
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Provider Name | LESLIE SPAHR HOLLAND
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Gender | Female
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Dates
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Enumeration Date | 03/13/2015
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Last Update Date | 03/13/2015
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Provider Practice Location Address
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Address Line | 14825 N OUTER 40 RD SUITE 200
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City | CHESTERFIELD
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State | MO
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Zip | 63017-2152
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Country | US
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Telephone | 314-336-2620
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Fax | 314-392-5086
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Provider Business Mailing Address
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Address Line | 14825 N OUTER 40 RD SUITE 200
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City | CHESTERFIELD
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State | MO
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Zip | 63017-2152
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Country | US
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Telephone | 314-336-2620
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Fax | 314-392-5086
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 231H00000X
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Taxonomy Name | Audiologist
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License Number | 01244
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License Number State | MO
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