Lakota Branch

Individual provider Active NPI Behavior Technician · Fountain, CO

NPI 1003747734 · NPPES record last updated May 29, 2026

Key facts

NPI
1003747734
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Technician 106S00000X
Practice address
6436 S US Highway 85-87 Ste U
Fountain, CO 80817-1007
Phone
(719) 822-0460
NPI assigned
May 29, 2026
Sex
Female
Sole proprietor
No

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X CO Yes

Addresses

Primary practice location

6436 S US Highway 85-87 Ste U
Fountain, CO 80817-1007

Mailing address

6436 S US Highway 85-87 Ste U
Fountain, CO 80817-1007
Phone (719) 822-0460

Other providers in Fountain, CO

All providers in Fountain, CO · Behavior Technician in Colorado

Sources for this page

Verify at the official NPI Registry.