Provider Demographics
NPI:1922352145
Name:HUSEBY, HOLLY MICHELLE KOWALCHUK (MS, BCBA)
Entity Type:Individual
Prefix:MRS
First Name:HOLLY
Middle Name:MICHELLE KOWALCHUK
Last Name:HUSEBY
Suffix:
Gender:F
Credentials:MS, BCBA
Other - Prefix:MS
Other - First Name:HOLLY
Other - Middle Name:MICHELLE
Other - Last Name:KOWALCHUK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7830 W ALAMEDA AVE STE 103-219
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80226-3093
Mailing Address - Country:US
Mailing Address - Phone:303-731-5457
Mailing Address - Fax:
Practice Address - Street 1:7550 W YALE AVE STE A135
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80227-3794
Practice Address - Country:US
Practice Address - Phone:303-731-5457
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-11-09
Last Update Date:2022-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst