Holly Kathryn Mangus
Individual provider Active NPI Speech-Language Pathologist · Derby, NY
NPI 1659929966 · NPPES record last updated Aug 29, 2019
Key facts
- NPI
- 1659929966
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- Practice address
- 7821 Erie Rd
Derby, NY 14047-9502 - Phone
- (716) 549-0585
- NPI assigned
- Aug 29, 2019
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bloom Creative Arts and Therapy Clinic | Past |
Accepting new patients | |
| Bloomiverse, LLC | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | Yes |
Addresses
Primary practice location
7821 Erie Rd
Derby, NY 14047-9502
Mailing address
3377 Lake Shore Rd
Buffalo, NY 14219-1437
Other providers in Derby, NY
- Lakeshore Chiropractic Wellness PLLC
- Lakeshore Family Medicine Assoc PC
- Lakeshore Family Medicine Associates PC
- Debra Sue Longbine
- Laura Ann Majkut
- Amy Beth Martinez
- Christopher J McCann
- Mary Beth McCormick
- Madison Elizabeth McDonagh
- Peter Samuel McQuiller
All providers in Derby, NY · Speech-Language Pathologist in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 29, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.