Provider Demographics
NPI:1043799059
Name:BURNS, HOLLY BROOKE
Entity Type:Individual
Prefix:
First Name:HOLLY
Middle Name:BROOKE
Last Name:BURNS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:605B ALABAMA ST
Mailing Address - Street 2:
Mailing Address - City:BEEBE
Mailing Address - State:AR
Mailing Address - Zip Code:72012-3601
Mailing Address - Country:US
Mailing Address - Phone:501-239-0037
Mailing Address - Fax:
Practice Address - Street 1:701 W DANDRIDGE ST
Practice Address - Street 2:
Practice Address - City:KENSETT
Practice Address - State:AR
Practice Address - Zip Code:72082-3857
Practice Address - Country:US
Practice Address - Phone:501-742-3221
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-09
Last Update Date:2018-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist