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NPI Code Detail

MEDICARE: HOLLY ANN BROLMANN

MEDICARE: HOLLY ANN BROLMANN
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 Analyst1-20-40942FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1861918773
Entity Type Code : Individual
Provider Name (Legal Business Name) : HOLLY ANN BROLMANN
Provider Business Mailing Address
First Line : 906 SEMINOLE DR
Second Line :
City : FORT PIERCE
State : FL
Zip : 34982-7648
Country : US
Telephone Number : 772-216-2501
Fax Number :
Provider Business Practice Location Address
First Line : 906 SEMINOLE DR
Second Line :
City : FORT PIERCE
State : FL
Zip : 34982-7648
Country : US
Telephone Number : 772-216-2501
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/22/2017
Last Update Date : 04/12/2022

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Directions to “ HOLLY ANN BROLMANN ” Practice Location

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