Provider Demographics
NPI:1114123809
Name:ALLING, HOLLY B (MA, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:HOLLY
Middle Name:B
Last Name:ALLING
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 1:8546 N CLOVERLEAF DR
Mailing Address - Street 2:
Mailing Address - City:HAYDEN
Mailing Address - State:ID
Mailing Address - Zip Code:83835-8259
Mailing Address - Country:US
Mailing Address - Phone:808-868-1416
Mailing Address - Fax:
Practice Address - Street 1:8546 N CLOVERLEAF DR
Practice Address - Street 2:
Practice Address - City:HAYDEN
Practice Address - State:ID
Practice Address - Zip Code:83835-8259
Practice Address - Country:US
Practice Address - Phone:808-868-1416
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-21
Last Update Date:2020-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALL00003359235Z00000X
HISP1120235Z00000X
IDSLP-3062235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist