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NPI Code Detail

MEDICARE: HOLLY MARIE HUIZAR

MEDICARE:   HOLLY MARIE HUIZAR
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
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1679071047
Entity Type Code : Individual
Provider Name (Legal Business Name) : HOLLY MARIE HUIZAR
Provider Business Mailing Address
First Line : 2431 W MALONE AVE
Second Line :
City : LUPTON
State : MI
Zip : 48635-9526
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 9001 MILLER RD STE 5
Second Line :
City : SWARTZ CREEK
State : MI
Zip : 48473-1115
Country : US
Telephone Number : 989-401-2244
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/31/2018
Last Update Date : 12/28/2018

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Directions to “ HOLLY MARIE HUIZAR ” Practice Location

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