Provider Demographics
NPI:1215471958
Name:CHAYTOR, HOLLIE
Entity type:Individual
Prefix:MS
First Name:HOLLIE
Middle Name:
Last Name:CHAYTOR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 LAKESHORE DR
Mailing Address - Street 2:
Mailing Address - City:HOPE
Mailing Address - State:AR
Mailing Address - Zip Code:71801-6002
Mailing Address - Country:US
Mailing Address - Phone:870-722-2723
Mailing Address - Fax:
Practice Address - Street 1:601 LAKESHORE DR
Practice Address - Street 2:
Practice Address - City:HOPE
Practice Address - State:AR
Practice Address - Zip Code:71801-6002
Practice Address - Country:US
Practice Address - Phone:870-722-2723
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-15
Last Update Date:2016-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR16-01622355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant