Individual
MARISA HOLTGREVEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, BCBA, LBA
Contact information
Practice address
1720 W ELFINDALE ST, SPRINGFIELD, MO 65807-1289
(417) 494-3274
(870) 641-7171
Mailing address
760 RUE SAINT FRANCOIS ST, FLORISSANT, MO 63031-4905
(314) 377-3274
(870) 641-7171
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
2021029719
MO
Other
Enumeration date
05/27/2021
Last updated
10/08/2024
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