Individual
HOLLY DENISE FITZPATRICK
Active
Sole proprietor
Provider details
NPI number
Gender
F
Contact information
Practice address
331 SIJEN AVE, WHITEMAN AFB, MO 65305-1269
(660) 687-4341
Mailing address
82 NE 1211, KNOB NOSTER, MO 65336-2262
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
6801077165
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6801077165
LICENSE #
MI
Enumeration date
08/29/2005
Last updated
07/08/2007
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