Provider Demographics
NPI:1972841062
Name:HOLM, KASEE NOEL (SLP)
Entity Type:Individual
Prefix:
First Name:KASEE
Middle Name:NOEL
Last Name:HOLM
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13538 VILLAGE PARK DR
Mailing Address - Street 2:215
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32837-7698
Mailing Address - Country:US
Mailing Address - Phone:321-872-7157
Mailing Address - Fax:407-730-2948
Practice Address - Street 1:13538 VILLAGE PARK DR
Practice Address - Street 2:215
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32837-7698
Practice Address - Country:US
Practice Address - Phone:321-872-7157
Practice Address - Fax:407-730-2948
Is Sole Proprietor?:No
Enumeration Date:2013-01-23
Last Update Date:2013-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSZ6129235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist