Individual
MICHAEL HOLLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RBT
Contact information
Practice address
14 SOCCER PARK RD, FENTON, MO 63026-2564
(314) 845-3900
(314) 845-3901
Mailing address
14 SOCCER PARK RD, FENTON, MO 63026-2564
(314) 845-3900
(314) 845-3901
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT20140660
MO
Other
Enumeration date
11/19/2020
Last updated
11/19/2020
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