1033731922 NPI number — MRS. BAILEY ELILZABETH HOLZHAUSEN MA CCC-SLP

Table of content: DR. PETER KH GO M.D. (NPI 1932202298)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1033731922 NPI number — MRS. BAILEY ELILZABETH HOLZHAUSEN MA CCC-SLP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HOLZHAUSEN
Provider First Name:
BAILEY
Provider Middle Name:
ELILZABETH
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
MA CCC-SLP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
BAKER
Provider Other First Name:
BAILEY
Provider Other Middle Name:
ELILZABETH
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
MA CCC-SLP
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1033731922
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/07/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PEDIATRIC COMMUNICATION SOLUTIONS
Provider Second Line Business Mailing Address:
2761 WASHINGTON DRIVE SUITE 111
Provider Business Mailing Address City Name:
NORMAN
Provider Business Mailing Address State Name:
OK
Provider Business Mailing Address Postal Code:
73069
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
405-438-0090
Provider Business Mailing Address Fax Number:
405-493-0717

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
PEDIATRIC COMMUNICATION SOLUTIONS
Provider Second Line Business Practice Location Address:
2761 WASHINGTON DRIVE SUITE 111
Provider Business Practice Location Address City Name:
NORMAN
Provider Business Practice Location Address State Name:
OK
Provider Business Practice Location Address Postal Code:
73069
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
405-438-0090
Provider Business Practice Location Address Fax Number:
405-493-0717
Provider Enumeration Date:
05/13/2020

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 235Z00000X , with the licence number:  5309 , registered in the state of OK ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)