Provider Demographics
NPI:1063686913
Name:HOLTGREWE, TERRI LINN (MA, CCC/SLP)
Entity Type:Individual
Prefix:MS
First Name:TERRI
Middle Name:LINN
Last Name:HOLTGREWE
Suffix:
Gender:F
Credentials:MA, CCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1725 THOELE RD
Mailing Address - Street 2:
Mailing Address - City:SAINT PETERS
Mailing Address - State:MO
Mailing Address - Zip Code:63376-3254
Mailing Address - Country:US
Mailing Address - Phone:636-851-4511
Mailing Address - Fax:
Practice Address - Street 1:1725 THOELE RD
Practice Address - Street 2:
Practice Address - City:SAINT PETERS
Practice Address - State:MO
Practice Address - Zip Code:63376-3254
Practice Address - Country:US
Practice Address - Phone:636-851-4511
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-22
Last Update Date:2008-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO02051235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist