Provider Demographics
NPI:1194154617
Name:HOLLINGER, DEBORAH (MA, CCC-SLP)
Entity type:Individual
Prefix:
First Name:DEBORAH
Middle Name:
Last Name:HOLLINGER
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3636 N RIDGE RD STE 400
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67205-1221
Mailing Address - Country:US
Mailing Address - Phone:316-977-8592
Mailing Address - Fax:
Practice Address - Street 1:3636 N RIDGE RD STE 400
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67205-1221
Practice Address - Country:US
Practice Address - Phone:316-977-8592
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-05
Last Update Date:2013-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS3114235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist