Individual
MARYJANE HOLLAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S., SLP-CCC
Contact information
Practice address
502 NW 199TH ST, RIDGEFIELD, WA 98642-5601
(360) 619-1500
(360) 619-1559
Mailing address
502 NW 199TH ST, RIDGEFIELD, WA 98642-5601
(360) 619-1500
(360) 619-1559
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12086484
ASHA
MD
Enumeration date
09/17/2012
Last updated
09/17/2012
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