Provider Demographics
NPI:1366594772
Name:RAYCHER, HOLLY STRACNER (MS)
Entity type:Individual
Prefix:MS
First Name:HOLLY
Middle Name:STRACNER
Last Name:RAYCHER
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 REMINGTON DR
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72204-8202
Mailing Address - Country:US
Mailing Address - Phone:501-850-8788
Mailing Address - Fax:501-850-8791
Practice Address - Street 1:5 REMINGTON DR
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72204-8202
Practice Address - Country:US
Practice Address - Phone:501-850-8787
Practice Address - Fax:501-850-8791
Is Sole Proprietor?:No
Enumeration Date:2007-01-17
Last Update Date:2012-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARSP#1386235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR133455721Medicaid