Provider Demographics
NPI:1831785757
Name:LORRIGAN, HOLLIE MARIE STEPIEN (BCBA)
Entity type:Individual
Prefix:
First Name:HOLLIE
Middle Name:MARIE STEPIEN
Last Name:LORRIGAN
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:HOLLIE
Other - Middle Name:M
Other - Last Name:STEPIEN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:BCBA
Mailing Address - Street 1:4586 N CHERRYVALE AVE
Mailing Address - Street 2:
Mailing Address - City:APPLETON
Mailing Address - State:WI
Mailing Address - Zip Code:54913-9365
Mailing Address - Country:US
Mailing Address - Phone:708-256-2594
Mailing Address - Fax:
Practice Address - Street 1:1800 S LAWE ST
Practice Address - Street 2:
Practice Address - City:APPLETON
Practice Address - State:WI
Practice Address - Zip Code:54915-2473
Practice Address - Country:US
Practice Address - Phone:920-268-1998
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-15
Last Update Date:2024-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1-20-46225103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst