Individual
HOLLY MCKENNA SCIELZO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
254 E 29TH ST, BREMERTON, WA 98310-2171
(570) 815-0204
Mailing address
254 E 29TH ST, BREMERTON, WA 98310-2171
(570) 815-0204
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
016550793-01
TRICARE SELECT
—
Enumeration date
02/22/2021
Last updated
02/22/2021
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