Provider Demographics
NPI:1770097552
Name:HOLLAND, STEVEN (SLP-ASSISTANT)
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:
Last Name:HOLLAND
Suffix:
Gender:M
Credentials:SLP-ASSISTANT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1032 LYNDA LN
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76013-3825
Mailing Address - Country:US
Mailing Address - Phone:817-247-8283
Mailing Address - Fax:
Practice Address - Street 1:1016 MAGNOLIA ST
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:TX
Practice Address - Zip Code:76063-1745
Practice Address - Country:US
Practice Address - Phone:817-299-4300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-11-30
Last Update Date:2017-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX330492355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant