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General NPI Number Information
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NPI Number | 1659317816
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Entity Type | Individual
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Provider Name | HOLLY LANELL CRAIG M.S., CCC-SLP
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Gender | Female
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Dates
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Enumeration Date | 06/22/2006
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Last Update Date | 11/18/2024
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Provider Practice Location Address
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Address Line | 2221 E POINTER TRL
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City | VAN BUREN
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State | AR
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Zip | 72956-2336
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Country | US
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Telephone | 479-474-7942
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Fax |
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Provider Business Mailing Address
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Address Line | 2017 S M ST
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City | FORT SMITH
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State | AR
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Zip | 72901-5249
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Country | US
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Telephone | 479-651-6631
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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 | SP # 2027
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License Number State | AR
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