Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst | 1-21-47303 | CO |
NPI | 1003336371 |
---|---|
Provider Name | Madison Holmes |
First Address | Aurora, CO 80015-1238 |
Second Address | Aurora, CO 80015-1238 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/06/2017 |
Last Update Date | 19/07/2021 |