Provider Demographics
NPI:1134449002
Name:PARR, HOLLY ANN (MA/CCC-SLP)
Entity type:Individual
Prefix:
First Name:HOLLY
Middle Name:ANN
Last Name:PARR
Suffix:
Gender:F
Credentials:MA/CCC-SLP
Other - Prefix:
Other - First Name:HOLLY
Other - Middle Name:ANN
Other - Last Name:PRICE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3009 WALNUT GROVE LN N
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55447-1568
Mailing Address - Country:US
Mailing Address - Phone:612-298-2984
Mailing Address - Fax:
Practice Address - Street 1:3009 WALNUT GROVE LN N
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:MN
Practice Address - Zip Code:55447-1568
Practice Address - Country:US
Practice Address - Phone:612-298-2984
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-02
Last Update Date:2022-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN8620235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist