Most Relevant Information
Provider Data
| NPI Number: | 1003257916 |
| Provider Name: | HOLLY L THIELE CCC-SLP |
| Entity Type: | Individual |
| Taxonomy Code: | 235Z00000X |
| Specialty: | Speech-Language Pathologist |
| License Number: | 5045 |
Most Important Dates
| Enumeration Date: | 07/09/2013 |
| Last Updated: | 09/27/2013 |
Provider Practice Location
2030 CHILHOWEE MEDICAL PARK
MARYVILLE
TN
378045285
Practice Location Phone/Fax
| Phone: | 8658923400 |
| Fax: | 8659823410 |
Provider Mailing Location
PO BOX 5209
MARYVILLE
TN
378025209
Provider Mailing Phone/Fax
| Phone: | 8659823400 |
| Fax: | 8659823410 |