Provider Demographics
NPI:1740588292
Name:HOLLAND, LAUREN ELIZABETH (SLP)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:ELIZABETH
Last Name:HOLLAND
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 1:494 LAKE HAMILTON DR
Mailing Address - Street 2:
Mailing Address - City:HOT SPRINGS
Mailing Address - State:AR
Mailing Address - Zip Code:71913-7424
Mailing Address - Country:US
Mailing Address - Phone:580-716-2030
Mailing Address - Fax:
Practice Address - Street 1:104 WOLF ST
Practice Address - Street 2:
Practice Address - City:PEARCY
Practice Address - State:AR
Practice Address - Zip Code:71964-9403
Practice Address - Country:US
Practice Address - Phone:501-767-4111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-03-08
Last Update Date:2011-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR2809235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR184469721Medicaid