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General NPI Number Information
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NPI Number | 1639087794
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Entity Type | Individual
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Provider Name | GRACIE HOLSONBACK
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Gender | Female
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Dates
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Enumeration Date | 08/31/2026
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Last Update Date | 08/31/2026
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Provider Practice Location Address
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Address Line | 4198 US HIGHWAY 431 STE B
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City | ALBERTVILLE
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State | AL
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Zip | 35950-0242
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Country | US
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Telephone | 256-486-2300
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Fax | 256-486-9580
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Provider Business Mailing Address
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Address Line | 455 ROY WHITT RD
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City | BOAZ
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State | AL
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Zip | 35956-2537
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Country | US
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Telephone | 256-960-6566
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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 | 6192
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License Number State | AL
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