Provider Demographics
NPI:1922861533
Name:HOLLAND, SAMANTHA (SLPA)
Entity Type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:
Last Name:HOLLAND
Suffix:
Gender:F
Credentials:SLPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20162 SW BIRCH ST STE 350
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660-0790
Mailing Address - Country:US
Mailing Address - Phone:714-396-8685
Mailing Address - Fax:
Practice Address - Street 1:20162 SW BIRCH ST STE 350
Practice Address - Street 2:
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660-0790
Practice Address - Country:US
Practice Address - Phone:714-396-8685
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-05
Last Update Date:2024-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA79702355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant