Provider Demographics
NPI:1992940571
Name:GAFFIN, HOLLY J (SLP)
Entity type:Individual
Prefix:
First Name:HOLLY
Middle Name:J
Last Name:GAFFIN
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31 SPIRAL DR
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:KY
Mailing Address - Zip Code:41042-1351
Mailing Address - Country:US
Mailing Address - Phone:859-525-1128
Mailing Address - Fax:859-371-0899
Practice Address - Street 1:31 SPIRAL DR
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:KY
Practice Address - Zip Code:41042-1351
Practice Address - Country:US
Practice Address - Phone:859-525-1128
Practice Address - Fax:859-371-0899
Is Sole Proprietor?:No
Enumeration Date:2008-12-10
Last Update Date:2008-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYKY-2248235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist