Kathy Lynn Holland

Individual provider Active NPI Behavior Technician · Cosmos, MN

NPI 1043068943 · NPPES record last updated May 7, 2024

Key facts

NPI
1043068943
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Technician 106S00000X
Practice address
320 Saturn St N Ste a
Cosmos, MN 56228-9757
Phone
(320) 877-7074
NPI assigned
May 7, 2024
Sex
Female
Sole proprietor
Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Practice roles

OrganizationSpecialtyStatusNew patients
SWWC Service Cooperatives Past
since May 12, 2024
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X Yes

Addresses

Primary practice location

320 Saturn St N Ste a
Cosmos, MN 56228-9757

Mailing address

320 Saturn St N Ste a
Cosmos, MN 56228-9757
Phone (320) 877-7074

Other providers in Cosmos, MN

All providers in Cosmos, MN · Behavior Technician in Minnesota

Sources for this page

Verify at the official NPI Registry.