Individual
AMALIE HOLLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
528 14TH ST, MODESTO, CA 95354-2503
(877) 828-8476
(209) 260-0430
Mailing address
5841 N WALNUT RD, TURLOCK, CA 95382-9528
(877) 828-8476
(209) 260-0430
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-03-1320
CA
Other
Enumeration date
11/27/2012
Last updated
11/27/2012
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