Provider Demographics
NPI:1528591765
Name:SENECAL, HOLLY (BCBA)
Entity Type:Individual
Prefix:
First Name:HOLLY
Middle Name:
Last Name:SENECAL
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26 HIGH ST APT 2
Mailing Address - Street 2:
Mailing Address - City:STAFFORD SPRINGS
Mailing Address - State:CT
Mailing Address - Zip Code:06076-1432
Mailing Address - Country:US
Mailing Address - Phone:413-992-7024
Mailing Address - Fax:
Practice Address - Street 1:304 INVERNESS WAY S STE 125
Practice Address - Street 2:
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80112-5820
Practice Address - Country:US
Practice Address - Phone:303-759-1342
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-05
Last Update Date:2017-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1-16-23848103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst