Provider Demographics
NPI:1417511734
Name:HOLMES, MICHALA L (SLP)
Entity Type:Individual
Prefix:
First Name:MICHALA
Middle Name:L
Last Name:HOLMES
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6180 HIGHWAY MM
Mailing Address - Street 2:
Mailing Address - City:HOUSE SPRINGS
Mailing Address - State:MO
Mailing Address - Zip Code:63051-2315
Mailing Address - Country:US
Mailing Address - Phone:636-671-3382
Mailing Address - Fax:636-671-1625
Practice Address - Street 1:16216 BAXTER RD STE 330
Practice Address - Street 2:
Practice Address - City:CHESTERFIELD
Practice Address - State:MO
Practice Address - Zip Code:63017-4778
Practice Address - Country:US
Practice Address - Phone:636-733-3330
Practice Address - Fax:636-773-3332
Is Sole Proprietor?:No
Enumeration Date:2019-04-23
Last Update Date:2022-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist