Provider Demographics
NPI:1710214457
Name:HOLZMAN, ADDIE WILLIFORD (MS, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:ADDIE
Middle Name:WILLIFORD
Last Name:HOLZMAN
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 1:2136 CLUB RD
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28205-3644
Mailing Address - Country:US
Mailing Address - Phone:704-332-8164
Mailing Address - Fax:
Practice Address - Street 1:2136 CLUB RD
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28205-3644
Practice Address - Country:US
Practice Address - Phone:704-332-8164
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-11-16
Last Update Date:2009-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC8741235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist