Provider Demographics
NPI:1033789797
Name:HOLLIS, ANNE-MARIE S (SLP)
Entity Type:Individual
Prefix:MRS
First Name:ANNE-MARIE
Middle Name:S
Last Name:HOLLIS
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:363 OAK CHASE LN
Mailing Address - Street 2:
Mailing Address - City:WAVERLY
Mailing Address - State:TN
Mailing Address - Zip Code:37185-2943
Mailing Address - Country:US
Mailing Address - Phone:161-535-1744
Mailing Address - Fax:
Practice Address - Street 1:77 E LAKE ST
Practice Address - Street 2:
Practice Address - City:CAMDEN
Practice Address - State:TN
Practice Address - Zip Code:38320-2019
Practice Address - Country:US
Practice Address - Phone:731-584-0942
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-25
Last Update Date:2021-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN4545235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist