Provider Demographics
NPI:1073281234
Name:HOLZER, ALESSA (MS CCC-SLP)
Entity type:Individual
Prefix:
First Name:ALESSA
Middle Name:
Last Name:HOLZER
Suffix:
Gender:F
Credentials:MS 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:PO BOX 306
Mailing Address - Street 2:
Mailing Address - City:CHERRY PLAIN
Mailing Address - State:NY
Mailing Address - Zip Code:12040-0306
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:17017 NY-22
Practice Address - Street 2:
Practice Address - City:PETERSBURG
Practice Address - State:NY
Practice Address - Zip Code:12138
Practice Address - Country:US
Practice Address - Phone:518-514-8470
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-02
Last Update Date:2023-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist