Alexandria Carbajal

Individual provider Active NPI Behavior Technician · Fountain, CO

NPI 1578289005 · NPPES record last updated Jan 23, 2023

Key facts

NPI
1578289005
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Technician 106S00000X
License
RBT-23-252556 (CO)
Practice address
319 Mount View LN
Fountain, CO 80817-1727
Phone
(719) 424-6472
NPI assigned
Oct 17, 2022
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

State licenses

LicenseStateTypeSpecialty
RBT-23-252556COMDBehavior Technician

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X RBT-23-252556 CO Yes

Addresses

Primary practice location

319 Mount View LN
Fountain, CO 80817-1727

Mailing address

319 Mount View LN
Fountain, CO 80817-1727
Phone (719) 424-6472

Other identifiers

IdentifierTypeStateIssuer
1790211605MedicaidCO

Other providers in Fountain, CO

All providers in Fountain, CO · Behavior Technician in Colorado

Sources for this page

Verify at the official NPI Registry.