Provider Demographics
NPI:1790915866
Name:WINDMEYER, HOLLY WICKER (CCC,SLP)
Entity Type:Individual
Prefix:MRS
First Name:HOLLY
Middle Name:WICKER
Last Name:WINDMEYER
Suffix:
Gender:F
Credentials:CCC,SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3109 SETH DR
Mailing Address - Street 2:
Mailing Address - City:SANFORD
Mailing Address - State:NC
Mailing Address - Zip Code:27330-1054
Mailing Address - Country:US
Mailing Address - Phone:919-777-9816
Mailing Address - Fax:
Practice Address - Street 1:3109 SETH DR
Practice Address - Street 2:
Practice Address - City:SANFORD
Practice Address - State:NC
Practice Address - Zip Code:27330-1054
Practice Address - Country:US
Practice Address - Phone:919-777-9816
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-22
Last Update Date:2009-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC6460235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist