Individual
MARISSA HOLLABAUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
209 W LANCASTER AVE, PAOLI, PA 19301-1749
(484) 965-9966
Mailing address
209 W LANCASTER AVE, PAOLI, PA 19301-1749
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-21-48389
—
106S00000X
Behavior Technician
RBT-19-85237
PA
Other
Enumeration date
02/18/2020
Last updated
03/24/2021
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