MEDICARE: MRS. HOLLY WINFIELD KLEIN M.S., CCC-SLP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	8969	NC
2	235Z00000X	Speech-Language Pathologist	58015297	NY

General Provider Information

NPI Number	:	1225301716
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. HOLLY WINFIELD KLEIN M.S., CCC-SLP

Provider Business Mailing Address
First Line	:	5704 LAUREL CREEK RD
Second Line	:
City	:	BANNER ELK
State	:	NC
Zip	:	28604-7372
Country	:	US
Telephone Number	:	828-964-0612
Fax Number	:

Provider Business Practice Location Address
First Line	:	2998 BROADSTONE RD
Second Line	:
City	:	SUGAR GROVE
State	:	NC
Zip	:	28679-9267
Country	:	US
Telephone Number	:	828-963-4712
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/15/2012
Last Update Date	:	02/15/2012

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Directions to “ MRS. HOLLY WINFIELD KLEIN M.S., CCC-SLP” Practice Location

Language	Start Address	Practice Location

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