Provider Demographics
NPI:1356938740
Name:HOLLAND, BETHANY RACHEL (AUD)
Entity type:Individual
Prefix:
First Name:BETHANY
Middle Name:RACHEL
Last Name:HOLLAND
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:723 HUBBEL ST
Mailing Address - Street 2:
Mailing Address - City:MAUMEE
Mailing Address - State:OH
Mailing Address - Zip Code:43537-3523
Mailing Address - Country:US
Mailing Address - Phone:419-309-2778
Mailing Address - Fax:
Practice Address - Street 1:1110 W MAIN CROSS ST STE G
Practice Address - Street 2:
Practice Address - City:FINDLAY
Practice Address - State:OH
Practice Address - Zip Code:45840-2423
Practice Address - Country:US
Practice Address - Phone:419-423-5492
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-31
Last Update Date:2020-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHA.02114231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist