Provider Demographics
NPI:1760875702
Name:PLACE, HOLLY SCHIMPF (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:HOLLY
Middle Name:SCHIMPF
Last Name:PLACE
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 1:625 SCIO ST
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14605-2660
Mailing Address - Country:US
Mailing Address - Phone:585-325-0935
Mailing Address - Fax:585-325-0935
Practice Address - Street 1:625 SCIO ST
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14605-2660
Practice Address - Country:US
Practice Address - Phone:585-325-0935
Practice Address - Fax:585-325-0935
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-16
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY024563235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist