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General NPI Number Information
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NPI Number | 1619690468
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Entity Type | Individual
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Provider Name | JANA GAY HOLUBEC MS, CCC/SLP
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Gender | Female
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Dates
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Enumeration Date | 09/26/2022
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Last Update Date | 09/26/2022
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Provider Practice Location Address
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Address Line | 205 W CHINA ST
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City | BRADY
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State | TX
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Zip | 76825-7437
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Country | US
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Telephone | 325-597-2590
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Fax |
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Provider Business Mailing Address
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Address Line | 12836 W FM 2028
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City | MELVIN
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State | TX
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Zip | 76858-8029
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Country | US
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Telephone | 325-456-0472
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Fax |
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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 | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 100667
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License Number State | TX
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