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NPI Code Detail

MEDICARE: MR. HARRISON RICHARDSON

MEDICARE: MR. HARRISON RICHARDSON
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

General Provider Information

NPI Number : 1336592070
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. HARRISON RICHARDSON
Provider Business Mailing Address
First Line : 2522 E BUENA VENTURA ST
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80909-3025
Country : US
Telephone Number : 208-992-6734
Fax Number :
Provider Business Practice Location Address
First Line : 2233 ACADEMY PL STE 200
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80909-1666
Country : US
Telephone Number : 719-301-0002
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/18/2016
Last Update Date : 06/12/2025

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Directions to “ MR. HARRISON RICHARDSON ” Practice Location

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