Provider Demographics
NPI:1952548380
Name:YORK, HOLLY A (BCBA)
Entity Type:Individual
Prefix:MRS
First Name:HOLLY
Middle Name:A
Last Name:YORK
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 1:115 ROLLEIGH RD E
Mailing Address - Street 2:
Mailing Address - City:CALHOUN
Mailing Address - State:LA
Mailing Address - Zip Code:71225-9580
Mailing Address - Country:US
Mailing Address - Phone:318-644-4464
Mailing Address - Fax:318-651-4842
Practice Address - Street 1:115 ROLLEIGH RD E
Practice Address - Street 2:
Practice Address - City:CALHOUN
Practice Address - State:LA
Practice Address - Zip Code:71225-9580
Practice Address - Country:US
Practice Address - Phone:318-644-4464
Practice Address - Fax:318-651-4842
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-07
Last Update Date:2013-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1-08-4659103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst