Provider Demographics
NPI:1760828867
Name:SATALOFF, HOLLY ALISE (MSEDCCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:HOLLY
Middle Name:ALISE
Last Name:SATALOFF
Suffix:
Gender:F
Credentials:MSEDCCC-SLP
Other - Prefix:MISS
Other - First Name:HOLLY
Other - Middle Name:ALISE
Other - Last Name:WAGNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:201 CEDAR ST
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:NJ
Mailing Address - Zip Code:08518-1502
Mailing Address - Country:US
Mailing Address - Phone:609-915-9752
Mailing Address - Fax:
Practice Address - Street 1:201 CEDAR ST
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:NJ
Practice Address - Zip Code:08518-1502
Practice Address - Country:US
Practice Address - Phone:609-915-9752
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-05-15
Last Update Date:2013-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41YS00389200235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist