Provider Demographics
NPI:1659744431
Name:HOLEN, KYLEE
Entity Type:Individual
Prefix:
First Name:KYLEE
Middle Name:
Last Name:HOLEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:KYLEE
Other - Middle Name:
Other - Last Name:DUTCHER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:505 14TH AVE
Mailing Address - Street 2:
Mailing Address - City:HOLDREGE
Mailing Address - State:NE
Mailing Address - Zip Code:68949-2002
Mailing Address - Country:US
Mailing Address - Phone:308-995-4339
Mailing Address - Fax:
Practice Address - Street 1:505 14TH AVE
Practice Address - Street 2:
Practice Address - City:HOLDREGE
Practice Address - State:NE
Practice Address - Zip Code:68949-2002
Practice Address - Country:US
Practice Address - Phone:308-995-4339
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-03
Last Update Date:2021-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist