Bailey Banwart

Individual provider Active NPI Behavior Technician · Commerce City, CO

NPI 1679142806 · NPPES record last updated Jun 22, 2021

Key facts

NPI
1679142806
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Technician 106S00000X
Practice address
12303 E 104TH PL Unit 105
Commerce City, CO 80022-2098
Phone
(720) 617-1574
NPI assigned
Jun 22, 2021
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 Yes

Addresses

Primary practice location

12303 E 104TH PL Unit 105
Commerce City, CO 80022-2098

Mailing address

5522 Lone Star Pkwy Ste 101
San Antonio, TX 78253-6719
Phone (210) 670-8028

Other providers in Commerce City, CO

All providers in Commerce City, CO · Behavior Technician in Colorado

Sources for this page

Verify at the official NPI Registry.