Provider Demographics
NPI:1184462533
Name:CIFUENTES HOLLINGER, COREY JOSEPH (CF-SLP)
Entity type:Individual
Prefix:
First Name:COREY
Middle Name:JOSEPH
Last Name:CIFUENTES HOLLINGER
Suffix:
Gender:X
Credentials:CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:729 S ARAPEEN DR # 1300
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84108-1218
Mailing Address - Country:US
Mailing Address - Phone:801-587-3550
Mailing Address - Fax:
Practice Address - Street 1:729 S ARAPEEN DR # 1300
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84108-1218
Practice Address - Country:US
Practice Address - Phone:801-587-3550
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-18
Last Update Date:2024-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT14026870-4104235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist