Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106E00000X | Assistant Behavior Analyst | MN |
NPI | 1063170868 |
---|---|
Provider Name | Rochelle Kari Holl |
First Address | Bloomington, MN 55425-1232 |
Second Address | Bloomington, MN 55425-1232 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/11/2021 |
Last Update Date | 30/11/2021 |