Healthcare Provider Details

I. General information

NPI: 1184055238
Provider Name (Legal Business Name): ALANNA HOLLBORN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/27/2013
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1300 W 4TH ST
GILLETTE WY
82716-3330
US

IV. Provider business mailing address

1300 W 4TH ST
GILLETTE WY
82716-3330
US

V. Phone/Fax

Practice location:
  • Phone: 888-924-2366
  • Fax: 888-263-5638
Mailing address:
  • Phone: 888-924-2366
  • Fax: 888-263-5638

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number002584
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: