Provider Demographics
NPI:1326759663
Name:GREEN, HOLLIE BOYER (AUD)
Entity type:Individual
Prefix:
First Name:HOLLIE
Middle Name:BOYER
Last Name:GREEN
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:HOLLIE
Other - Middle Name:
Other - Last Name:BOYER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:AUD
Mailing Address - Street 1:8075 MADISON BLVD SUITE 108
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:AL
Mailing Address - Zip Code:35758
Mailing Address - Country:US
Mailing Address - Phone:256-319-4327
Mailing Address - Fax:256-461-1228
Practice Address - Street 1:433 N PINE STREET
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:AL
Practice Address - Zip Code:35630
Practice Address - Country:US
Practice Address - Phone:256-740-8383
Practice Address - Fax:256-461-1228
Is Sole Proprietor?:No
Enumeration Date:2022-12-07
Last Update Date:2025-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL13612231H00000X
AL5272231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist