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NPI Code Detail

MEDICARE: MRS. HOLLY LAMB ELLIS SLP

MEDICARE: MRS. HOLLY LAMB ELLIS 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 Pathologist10901NC

Other Identifiers

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

General Provider Information

NPI Number : 1821401753
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. HOLLY LAMB ELLIS SLP
Provider Business Mailing Address
First Line : 2604 FALLS RIVER AVE
Second Line :
City : RALEIGH
State : NC
Zip : 27614-9875
Country : US
Telephone Number : 252-342-4189
Fax Number :
Provider Business Practice Location Address
First Line : 2604 FALLS RIVER AVE
Second Line :
City : RALEIGH
State : NC
Zip : 27614-9875
Country : US
Telephone Number : 252-342-4189
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/09/2014
Last Update Date : 07/09/2020

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Directions to “ MRS. HOLLY LAMB ELLIS SLP” Practice Location

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