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General NPI Number Information
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NPI Number | 1922352145
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Entity Type | Individual
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Provider Name | HOLLY MICHELLE KOWALCHUK HUSEBY M.S., BCBA
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Gender | Female
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Dates
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Enumeration Date | 11/09/2012
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Last Update Date | 01/08/2022
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Provider Practice Location Address
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Address Line | 7550 W YALE AVE STE A135
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City | LAKEWOOD
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State | CO
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Zip | 80227-3794
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Country | US
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Telephone | 303-731-5457
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Fax |
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Provider Business Mailing Address
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Address Line | 7830 W ALAMEDA AVE STE 103-219
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City | LAKEWOOD
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State | CO
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Zip | 80226-3093
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Country | US
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Telephone | 303-731-5457
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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