Provider Demographics
NPI:1225301716
Name:KLEIN, HOLLY WINFIELD (MS, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:HOLLY
Middle Name:WINFIELD
Last Name:KLEIN
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 1:5704 LAUREL CREEK RD
Mailing Address - Street 2:
Mailing Address - City:BANNER ELK
Mailing Address - State:NC
Mailing Address - Zip Code:28604-7372
Mailing Address - Country:US
Mailing Address - Phone:828-964-0612
Mailing Address - Fax:
Practice Address - Street 1:2998 BROADSTONE RD
Practice Address - Street 2:
Practice Address - City:SUGAR GROVE
Practice Address - State:NC
Practice Address - Zip Code:28679-9267
Practice Address - Country:US
Practice Address - Phone:828-963-4712
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-02-15
Last Update Date:2012-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC8969235Z00000X
NY58015297235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist