Individual
MRS. JACQUELYN ELIZABETH HOLMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
721 COMMERCE DR, WOODBURY, MN 55125-9118
(612) 767-7222
Mailing address
721 COMMERCE DR, WOODBURY, MN 55125-9118
(612) 767-7222
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
0001949
CO
235Z00000X
Speech-Language Pathologist
474968
MN
235Z00000X
Speech-Language Pathologist
Primary
518290
MN
235Z00000X
Speech-Language Pathologist
9145
MN
Other
Enumeration date
12/02/2014
Last updated
04/13/2022
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