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NPI Code Detail

MEDICARE: ALEXANDRA HOLUB M.S. CCC-SLP

MEDICARE: ALEXANDRA HOLUB 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
1235Z00000XSpeech-Language Pathologist6001SC

General Provider Information

NPI Number : 1336670660
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALEXANDRA HOLUB M.S. CCC-SLP
Provider Business Mailing Address
First Line : 56 GENESIS DR
Second Line :
City : LAKE CITY
State : SC
Zip : 29560-5531
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 56 GENESIS DR
Second Line :
City : LAKE CITY
State : SC
Zip : 29560-5531
Country : US
Telephone Number : 843-389-3685
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/27/2017
Last Update Date : 03/27/2017

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Directions to “ ALEXANDRA HOLUB M.S. CCC-SLP” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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