Provider Demographics
NPI:1609109800
Name:HONEYCUTT, HOLLY BROOKE (MS, CCC-SLP)
Entity Type:Individual
Prefix:MISS
First Name:HOLLY
Middle Name:BROOKE
Last Name:HONEYCUTT
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 1:7546 NEEDLEFISH CT
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28411-7271
Mailing Address - Country:US
Mailing Address - Phone:910-232-2413
Mailing Address - Fax:
Practice Address - Street 1:2744 S 17TH ST
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28412-6606
Practice Address - Country:US
Practice Address - Phone:910-794-3319
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-08
Last Update Date:2009-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC8236235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist