Individual
HOLLY MARIE CREAMER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
971 E. WICHITA AVE., RUSSELL, KS 67665
(785) 657-7464
(785) 445-4042
Mailing address
971 E. WICHITA AVE., RUSSELL, KS 67665
(785) 657-7464
(785) 445-4042
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
—
—
222Q00000X
Developmental Therapist
—
KS
385HR2055X
Child Mental Illness Respite Care
Primary
—
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201234000A
—
KS
Enumeration date
11/13/2018
Last updated
05/28/2019
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