Autumn Broyles

Individual provider Active NPI Behavior Technician · Fountain, CO

NPI 1972280469 · NPPES record last updated Aug 31, 2026

Key facts

NPI
1972280469
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Technician 106S00000X
Practice address
901 N Santa Fe Ave
Fountain, CO 80817-1738
Phone
(719) 822-0550
NPI assigned
Jun 28, 2023
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

901 N Santa Fe Ave
Fountain, CO 80817-1738

Mailing address

2233 Academy PL Ste 200
Colorado Springs, CO 80909-1666

Other providers in Fountain, CO

All providers in Fountain, CO · Behavior Technician in Colorado

Sources for this page

Verify at the official NPI Registry.