MEDICARE: MS. CAROLYN NOELLE HOLLIFIELD MS 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	6671	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1740216647
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. CAROLYN NOELLE HOLLIFIELD MS CCC SLP

Provider Business Mailing Address
First Line	:	PO BOX 208
Second Line	:
City	:	PINE LEVEL
State	:	NC
Zip	:	27568-0208
Country	:	US
Telephone Number	:	919-219-7614
Fax Number	:	919-882-1489

Provider Business Practice Location Address
First Line	:	116 JAMES DR
Second Line	:
City	:	SELMA
State	:	NC
Zip	:	27576-9381
Country	:	US
Telephone Number	:	919-219-7614
Fax Number	:	919-882-1489

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

Provider Enumeration Date	:	06/23/2006
Last Update Date	:	01/02/2014

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Directions to “ MS. CAROLYN NOELLE HOLLIFIELD MS CCC SLP” Practice Location

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