Provider Demographics
NPI:1033778915
Name:HOLLE, SONJA NICOLE (MA, CCC-SLP/L)
Entity Type:Individual
Prefix:MRS
First Name:SONJA
Middle Name:NICOLE
Last Name:HOLLE
Suffix:
Gender:F
Credentials:MA, CCC-SLP/L
Other - Prefix:
Other - First Name:SONJA
Other - Middle Name:
Other - Last Name:MELCHER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:WSU SPEECH LANGUAGE HEALING CLINIC
Mailing Address - Street 2:1845 FAIRMONT ST. BOX 99
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67260
Mailing Address - Country:US
Mailing Address - Phone:316-978-3289
Mailing Address - Fax:316-978-7264
Practice Address - Street 1:WSU SPEECH LANGUAGE HEALING CLINIC
Practice Address - Street 2:5015 E 29TH ST. N, ENTRANCE T
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67220
Practice Address - Country:US
Practice Address - Phone:316-978-3192
Practice Address - Fax:316-978-7264
Is Sole Proprietor?:No
Enumeration Date:2019-06-13
Last Update Date:2019-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS2156235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist