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Individual
KENNETH L HOLLEY JR.
Active
Individual
KENNETH L HOLLEY JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-20-128052
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5
S
—
Enumeration date
07/14/2020
Last updated
04/13/2022
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