Individual
KELLY HOLLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RBT
Contact information
Practice address
18384 NAEGER LN, STE GENEVIEVE, MO 63670-9116
(573) 535-8315
Mailing address
8058 FOX HOLLOW, BARNHART, MO 63012
(314) 939-7007
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
BACB550200
MO
Other
Enumeration date
06/10/2020
Last updated
06/10/2020
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