Individual
ANNEY RENEE FAHRENHOLZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S., BCBA
Contact information
Practice address
510 E WISCONSIN AVE, APPLETON, WI 54911-4865
(920) 257-4601
Mailing address
2145 LE CHATEAU DR, BROOKFIELD, WI 53045-5056
(402) 871-7545
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
154-140
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100009466
—
WI
Enumeration date
12/13/2016
Last updated
12/13/2016
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