MEDICARE: MRS. AMBER MARIE REINER MS, BCBA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103K00000X	Behavior Analyst	1-13-13932	TX

General Provider Information

NPI Number	:	1063853430
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. AMBER MARIE REINER MS, BCBA

Provider Business Mailing Address
First Line	:	1406 CENTAUR CIR
Second Line	:
City	:	LAFAYETTE
State	:	CO
Zip	:	80026-1432
Country	:	US
Telephone Number	:	720-837-2348
Fax Number	:	303-559-5657

Provider Business Practice Location Address
First Line	:	1200 W SOUTH BOULDER RD
Second Line	:	SUITE 203
City	:	LAFAYETTE
State	:	CO
Zip	:	80026-3546
Country	:	US
Telephone Number	:	720-837-2348
Fax Number	:	303-559-5657

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/12/2013
Last Update Date	:	03/01/2016

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