MEDICARE: SKYLLER ARMENTA

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	106S00000X	Behavior Technician	BACB345035	CO

General Provider Information

NPI Number	:	1144767740
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SKYLLER ARMENTA

Provider Business Mailing Address
First Line	:	3959 E BIJOU ST
Second Line	:	APT 317
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80909-6848
Country	:	US
Telephone Number	:	817-458-2463
Fax Number	:

Provider Business Practice Location Address
First Line	:	3959 E BIJOU ST
Second Line	:	APT 317
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80909-6848
Country	:	US
Telephone Number	:	817-458-2463
Fax Number	:

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

Provider Enumeration Date	:	01/21/2017
Last Update Date	:	01/21/2017

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Directions to “ SKYLLER ARMENTA ” Practice Location

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