Individual
ERICA HOLWAGER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
18521 E QUEEN CREEK RD, SUITE 105-627, QUEEN CREEK, AZ 85142-5866
(480) 361-1025
Mailing address
18521 E QUEEN CREEK RD, SUITE 105-627, QUEEN CREEK, AZ 85142-5866
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
26216969985242A002
TRICARE
AZ
Enumeration date
09/03/2008
Last updated
10/18/2016
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