Individual
HOLLYWOOD HERMANSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LSW
Contact information
Practice address
1470 INDUSTRIAL DR NW, ROCHESTER, MN 55901-0700
(507) 322-7751
Mailing address
507 UNION ST NE, CHATFIELD, MN 55923-1052
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
104100000X
Social Worker
28985
MN
106S00000X
Behavior Technician
—
—
Other
Enumeration date
07/29/2020
Last updated
10/04/2024
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