Provider Demographics
NPI:1164732632
Name:MAUSKAPF, HOLLY W (CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:HOLLY
Middle Name:W
Last Name:MAUSKAPF
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7401 S BROADWAY
Mailing Address - Street 2:
Mailing Address - City:RED HOOK
Mailing Address - State:NY
Mailing Address - Zip Code:12571-1748
Mailing Address - Country:US
Mailing Address - Phone:845-758-2241
Mailing Address - Fax:
Practice Address - Street 1:9 MILL RD
Practice Address - Street 2:
Practice Address - City:RED HOOK
Practice Address - State:NY
Practice Address - Zip Code:12571-2104
Practice Address - Country:US
Practice Address - Phone:845-758-2241
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-10-18
Last Update Date:2010-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011204-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist