Provider Demographics
NPI:1467615443
Name:CHRISTIAN, HOLLY MARIA (CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:HOLLY
Middle Name:MARIA
Last Name:CHRISTIAN
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 1:16 GRANDVIEW ST
Mailing Address - Street 2:APT 2
Mailing Address - City:HUNTINGTON
Mailing Address - State:NY
Mailing Address - Zip Code:11743-3548
Mailing Address - Country:US
Mailing Address - Phone:845-649-6664
Mailing Address - Fax:
Practice Address - Street 1:36 HILLWOOD DR
Practice Address - Street 2:
Practice Address - City:HUNTINGTON STATION
Practice Address - State:NY
Practice Address - Zip Code:11746-1343
Practice Address - Country:US
Practice Address - Phone:845-649-6664
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-09
Last Update Date:2019-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY58015504235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist