Provider Demographics
NPI:1134316409
Name:SLASON, HOLLY LOUISE
Entity Type:Individual
Prefix:MS
First Name:HOLLY
Middle Name:LOUISE
Last Name:SLASON
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 1:11091 SE LEVY COUNTY ROAD 337
Mailing Address - Street 2:
Mailing Address - City:DUNNELLON
Mailing Address - State:FL
Mailing Address - Zip Code:34431-7960
Mailing Address - Country:US
Mailing Address - Phone:956-244-5191
Mailing Address - Fax:
Practice Address - Street 1:11091 SE LEVY COUNTY ROAD 337
Practice Address - Street 2:
Practice Address - City:DUNNELLON
Practice Address - State:FL
Practice Address - Zip Code:34431-7960
Practice Address - Country:US
Practice Address - Phone:956-244-5191
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-10-01
Last Update Date:2017-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX326292355S0801X
222Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist
No2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant