Provider Demographics
NPI:1417395278
Name:HOLTZ, CARA A (MS, BCBA)
Entity Type:Individual
Prefix:MRS
First Name:CARA
Middle Name:A
Last Name:HOLTZ
Suffix:
Gender:F
Credentials:MS, BCBA
Other - Prefix:
Other - First Name:CARA
Other - Middle Name:A
Other - Last Name:HOLTZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2910 ENLOE ST STE 103
Mailing Address - Street 2:
Mailing Address - City:HUDSON
Mailing Address - State:WI
Mailing Address - Zip Code:54016-4539
Mailing Address - Country:US
Mailing Address - Phone:612-207-3555
Mailing Address - Fax:715-808-8533
Practice Address - Street 1:2910 ENLOE ST STE 103
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:WI
Practice Address - Zip Code:54016-4539
Practice Address - Country:US
Practice Address - Phone:612-207-3555
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-13
Last Update Date:2024-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI52-140103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst