Individual
MRS. LARYSSA MARCILE HOTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, BCBA
Contact information
Practice address
2418 E JOYCE BLVD, FAYETTEVILLE, AR 72703-4519
(479) 871-7994
Mailing address
2722 W VANIKE DR, FAYETTEVILLE, AR 72704-7547
(918) 323-2143
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-16-24869
AR
Other
Enumeration date
01/29/2017
Last updated
01/29/2017
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