Provider Demographics
NPI:1891146171
Name:HOLKON, INALBYS
Entity Type:Individual
Prefix:
First Name:INALBYS
Middle Name:
Last Name:HOLKON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6290 W 24TH CT
Mailing Address - Street 2:B5-107
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33016-4344
Mailing Address - Country:US
Mailing Address - Phone:786-390-8843
Mailing Address - Fax:
Practice Address - Street 1:6290 W 24TH CT
Practice Address - Street 2:B5-107
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33016-4344
Practice Address - Country:US
Practice Address - Phone:786-390-8843
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-28
Last Update Date:2022-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-15-3501-22551106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician