Susan Emerald Tanner

Individual provider Active NPI Behavior Technician · Wellington, CO

NPI 1669916953 · NPPES record last updated Dec 6, 2016

Key facts

NPI
1669916953
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Technician 106S00000X
Practice address
2551 E County Road 62E
Wellington, CO 80549-1502
Phone
(318) 446-3238
Fax
(970) 295-4052
NPI assigned
Dec 6, 2016
Sex
Female
Sole proprietor
No

Organizations & group practices 2

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
Tanner Autism Services of Colorado Current Accepting new patients
Tanner Autism Services of Colorado Current Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X Yes

Addresses

Primary practice location

2551 E County Road 62E
Wellington, CO 80549-1502

Mailing address

2551 E County Road 62E
Wellington, CO 80549-1502
Phone (318) 446-3238

Other providers in Wellington, CO

All providers in Wellington, CO · Behavior Technician in Colorado

Sources for this page

Verify at the official NPI Registry.