Provider Demographics
NPI:1932989688
Name:HOLLABAUGH, CLAIRE ELAINE (CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:CLAIRE
Middle Name:ELAINE
Last Name:HOLLABAUGH
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1050 HARVARD ST APT 2
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14610-1720
Mailing Address - Country:US
Mailing Address - Phone:214-354-0472
Mailing Address - Fax:
Practice Address - Street 1:150 HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14620-3024
Practice Address - Country:US
Practice Address - Phone:585-760-1300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-02
Last Update Date:2023-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY033251-01235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist