Provider Demographics
NPI:1205952629
Name:HOLLINGSHEAD, CHRISTA LEIGH (MA CCC SLP)
Entity type:Individual
Prefix:MRS
First Name:CHRISTA
Middle Name:LEIGH
Last Name:HOLLINGSHEAD
Suffix:
Gender:F
Credentials:MA CCC SLP
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:296 OBSERVATION POINTE DR
Mailing Address - Street 2:
Mailing Address - City:SOMERSET
Mailing Address - State:KY
Mailing Address - Zip Code:42503-3785
Mailing Address - Country:US
Mailing Address - Phone:606-875-7391
Mailing Address - Fax:
Practice Address - Street 1:129 PARK AVE
Practice Address - Street 2:
Practice Address - City:SOMERSET
Practice Address - State:KY
Practice Address - Zip Code:42501-1785
Practice Address - Country:US
Practice Address - Phone:606-677-1166
Practice Address - Fax:606-451-3386
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYKY 2252235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist