Provider Demographics
NPI:1770864365
Name:GARRETT, HOLLY ELIZABETH (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:HOLLY
Middle Name:ELIZABETH
Last Name:GARRETT
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 1:436 SCENIC VIEW DR
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30339-3644
Mailing Address - Country:US
Mailing Address - Phone:919-888-2939
Mailing Address - Fax:
Practice Address - Street 1:126 N SALEM ST
Practice Address - Street 2:SUITE 201
Practice Address - City:APEX
Practice Address - State:NC
Practice Address - Zip Code:27502-1428
Practice Address - Country:US
Practice Address - Phone:877-390-1887
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-08
Last Update Date:2011-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GASLP007563235Z00000X
SCSLP4871235Z00000X
MD06484235Z00000X
NC9455235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist