Provider Demographics
NPI:1326219635
Name:HOLLOWAY, MELISSA ANNE (MA CFY-SLP)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:ANNE
Last Name:HOLLOWAY
Suffix:
Gender:F
Credentials:MA CFY-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4401 E COLONIAL DR
Mailing Address - Street 2:107
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32803-5200
Mailing Address - Country:US
Mailing Address - Phone:407-898-5060
Mailing Address - Fax:407-898-5185
Practice Address - Street 1:4401 E COLONIAL DR
Practice Address - Street 2:107
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32803-5200
Practice Address - Country:US
Practice Address - Phone:407-898-5060
Practice Address - Fax:407-898-5185
Is Sole Proprietor?:No
Enumeration Date:2008-03-13
Last Update Date:2008-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSZ4293235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist