Provider Demographics
NPI:1801218607
Name:SHAPIRO, HOLLY (PHD SLP-CCC)
Entity Type:Individual
Prefix:DR
First Name:HOLLY
Middle Name:
Last Name:SHAPIRO
Suffix:
Gender:F
Credentials:PHD SLP-CCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:89 LINCOLNWOOD RD
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60035-5229
Mailing Address - Country:US
Mailing Address - Phone:847-433-5878
Mailing Address - Fax:847-433-5848
Practice Address - Street 1:89 LINCOLNWOOD RD
Practice Address - Street 2:
Practice Address - City:HIGHLAND PARK
Practice Address - State:IL
Practice Address - Zip Code:60035-5229
Practice Address - Country:US
Practice Address - Phone:847-433-5878
Practice Address - Fax:847-433-5848
Is Sole Proprietor?:No
Enumeration Date:2014-01-13
Last Update Date:2014-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146001002235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist