Provider Demographics
NPI:1023312873
Name:ALMON, HOLLY (MS, BCBA)
Entity type:Individual
Prefix:
First Name:HOLLY
Middle Name:
Last Name:ALMON
Suffix:
Gender:F
Credentials:MS, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13010 NE 20TH ST
Mailing Address - Street 2:STE. 300
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98005-2034
Mailing Address - Country:US
Mailing Address - Phone:206-650-7951
Mailing Address - Fax:
Practice Address - Street 1:13010 NE 20TH ST
Practice Address - Street 2:STE. 300
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98005-2034
Practice Address - Country:US
Practice Address - Phone:206-650-7951
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-01-07
Last Update Date:2017-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1-04-1656103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
1-04-1656OtherBEHAVIOR ANALYST CERTIFICATION BOARD
WACL60172211OtherWASHINGTON STATE DEPARTMENT OF HEALTH
WACG60377225OtherAGENCY AFFILIATED COUNSELOR