Provider Demographics
NPI:1821365719
Name:HOLCOMB, ELIZABETH PATRICIA (SLP-CCC)
Entity Type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:PATRICIA
Last Name:HOLCOMB
Suffix:
Gender:F
Credentials:SLP-CCC
Other - Prefix:MISS
Other - First Name:ELIZABETH
Other - Middle Name:PATRICIA
Other - Last Name:BAKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:19809 FILBERT RD
Mailing Address - Street 2:
Mailing Address - City:BOTHELL
Mailing Address - State:WA
Mailing Address - Zip Code:98012-9617
Mailing Address - Country:US
Mailing Address - Phone:425-280-0903
Mailing Address - Fax:
Practice Address - Street 1:19809 FILBERT RD
Practice Address - Street 2:
Practice Address - City:BOTHELL
Practice Address - State:WA
Practice Address - Zip Code:98012-9617
Practice Address - Country:US
Practice Address - Phone:425-280-0903
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-21
Last Update Date:2011-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALL60025305235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist