Individual
HOLLI HENNINGSEN JERDES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
905 CARLYON AVE SE, OLYMPIA, WA 98501-3503
(360) 688-4321
Mailing address
905 CARLYON AVE SE STE A, OLYMPIA, WA 98501-3503
(360) 688-4231
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
1073813
CA
103K00000X
Behavior Analyst
Primary
BA60760954
WA
Other
Enumeration date
02/03/2012
Last updated
05/17/2022
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