Holly Wade, SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SP1984 Issued in AR

Practice address

216 Main St
Lake Village, AR 71653-1916

Phone

(870) 265-3950

Fax

(870) 265-2525

NPI assigned

Feb 21, 2008

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Occupational Therapy Services Inc.

  • Pediatric Occupational Therapist
  • Lake Village, AR
  • NPI 1942314893

  Speech-Language Pathologist

  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1203552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1203552000000",
    "number": "1659540813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "216 MAIN ST",
            "city": "LAKE VILLAGE",
            "state": "AR",
            "postal_code": "716531916",
            "telephone_number": "870-265-3950",
            "fax_number": "870-265-2525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "216 MAIN ST",
            "city": "LAKE VILLAGE",
            "state": "AR",
            "postal_code": "716531916",
            "telephone_number": "870-265-3950",
            "fax_number": "870-265-2525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WADE",
        "first_name": "HOLLY",
        "credential": "SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-02-21",
        "last_updated": "2008-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "AR",
            "license": "SP1984",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eva Jean Sykes, D.T.
• The Functional Pharmacist Inc
• TLC Early Learning and Play Center
• Robenette Toney
• Theerasak Tuangsithtanon, M.D.
• Lisa Jane Wagoner, MHPP
• Jessica Ann Walthall, OT-A
• Victoria Washington
• Robert F Wawrzynek Jr., PA-C
• Martha Weatheroy, MHPP

• Speech-Language Pathologist in Lake Village, AR
• Providers in Lake Village, AR by specialty
• Speech-Language Pathologist in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.