Individual
MS. HOLLY LEANNE FERNALLD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
906 W WEILE AVE, SPOKANE, WA 99208-6263
(509) 354-3382
(509) 354-3404
Mailing address
327 W IVANHOE RD, SPOKANE, WA 99218-2167
(509) 466-7951
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
LL60576946
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LL605769946
DOH
WA
Enumeration date
09/19/2014
Last updated
11/04/2021
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