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NPI Code Detail

MEDICARE: SAMANTHA PUISSANT

MEDICARE: SAMANTHA PUISSANT
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
1106S00000XBehavior Technician
2106E00000XAssistant Behavior Analyst18393CO

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1215591227
Entity Type Code : Individual
Provider Name (Legal Business Name) : SAMANTHA PUISSANT
Provider Business Mailing Address
First Line : 13725 STRUTHERS RD
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80921-2451
Country : US
Telephone Number : 719-301-5100
Fax Number :
Provider Business Practice Location Address
First Line : 6140 TUTT BLVD STE 200
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80923-3576
Country : US
Telephone Number : 719-301-5100
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/24/2019
Last Update Date : 10/07/2025

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Directions to “ SAMANTHA PUISSANT ” Practice Location

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