Provider Demographics
NPI:1407320773
Name:HORLACHER, HOLLI TERESA
Entity Type:Individual
Prefix:MRS
First Name:HOLLI
Middle Name:TERESA
Last Name:HORLACHER
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 1:899 MOUNTAIN AVE STE 1A
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07081-3403
Mailing Address - Country:US
Mailing Address - Phone:973-218-6394
Mailing Address - Fax:
Practice Address - Street 1:899 MOUNTAIN AVE STE 1A
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07081-3403
Practice Address - Country:US
Practice Address - Phone:973-218-6394
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-18
Last Update Date:2019-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41YS00604200235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist