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Individual

PAIGE HOLMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
7001 E FISH LAKE RD, MAPLE GROVE, MN 55311-2841
(651) 332-0574
Mailing address
14135 36TH AVE N, PLYMOUTH, MN 55447-5309
(651) 332-0574

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-22-62263
MN
106S00000X
Behavior Technician

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
53593538
HEALTH PARTNERS
Enumeration date
11/21/2017
Last updated
11/02/2023
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