Individual
AMANDA HOLLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1613 PROSPECT PKWY, SUITE 110, FORT COLLINS, CO 80525-9769
(303) 989-8169
Mailing address
1613 PROSPECT PKWY, SUITE 110, FORT COLLINS, CO 80525-9769
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
12/17/2019
Last updated
12/17/2019
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