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NPI Code Detail

MEDICARE: HOLLIE KONING

MEDICARE:   HOLLIE  KONING
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103K00000XBehavior Analyst7401001599MI

General Provider Information

NPI Number : 1386208676
Entity Type Code : Individual
Provider Name (Legal Business Name) : HOLLIE KONING
Provider Business Mailing Address
First Line : 200 W SPRING ST
Second Line :
City : MARQUETTE
State : MI
Zip : 49855-4661
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2353 BADGER ST
Second Line :
City : MARQUETTE
State : MI
Zip : 49855-2303
Country : US
Telephone Number : 906-273-1121
Fax Number : 906-225-7606
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/23/2019
Last Update Date : 03/01/2022

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Directions to “ HOLLIE KONING ” Practice Location

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