Provider Demographics
NPI:1174737217
Name:HOLLIS, CATHRYN CRANFORD (AUD, CCC-A)
Entity type:Individual
Prefix:MRS
First Name:CATHRYN
Middle Name:CRANFORD
Last Name:HOLLIS
Suffix:
Gender:F
Credentials:AUD, CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4020 RICHARDS RD STE B
Mailing Address - Street 2:
Mailing Address - City:NORTH LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72117-2744
Mailing Address - Country:US
Mailing Address - Phone:501-975-7550
Mailing Address - Fax:501-975-7553
Practice Address - Street 1:4020 RICHARDS RD STE B
Practice Address - Street 2:
Practice Address - City:NORTH LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72117-2744
Practice Address - Country:US
Practice Address - Phone:501-975-7550
Practice Address - Fax:501-975-7553
Is Sole Proprietor?:No
Enumeration Date:2007-05-09
Last Update Date:2013-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARA#283231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR171793720Medicaid
AR171793720Medicaid
AR5A773Medicare PIN