Provider Demographics
NPI:1124206206
Name:TOOLEY, HOLLIE MICHELLE (MS CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:HOLLIE
Middle Name:MICHELLE
Last Name:TOOLEY
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2310 STATE ROUTE 2584
Mailing Address - Street 2:
Mailing Address - City:CENTRAL CITY
Mailing Address - State:KY
Mailing Address - Zip Code:42330-6277
Mailing Address - Country:US
Mailing Address - Phone:270-525-9506
Mailing Address - Fax:
Practice Address - Street 1:2310 STATE ROUTE 2584
Practice Address - Street 2:
Practice Address - City:CENTRAL CITY
Practice Address - State:KY
Practice Address - Zip Code:42330-6277
Practice Address - Country:US
Practice Address - Phone:270-525-9506
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-31
Last Update Date:2008-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYKY-2401235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist