Provider Demographics
NPI:1962753822
Name:STANKOSKY, HOLLY
Entity type:Individual
Prefix:MRS
First Name:HOLLY
Middle Name:
Last Name:STANKOSKY
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:HOLLY
Other - Middle Name:
Other - Last Name:STANKOSKY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MS, CCC-SLP
Mailing Address - Street 1:865 E SILVER SHADOWS DR
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:UT
Mailing Address - Zip Code:84780-8286
Mailing Address - Country:US
Mailing Address - Phone:435-467-9909
Mailing Address - Fax:435-652-6627
Practice Address - Street 1:865 E SILVER SHADOWS DR
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:UT
Practice Address - Zip Code:84780-8286
Practice Address - Country:US
Practice Address - Phone:435-467-9909
Practice Address - Fax:435-652-6627
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-01
Last Update Date:2012-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT376298-4102235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist