MEDICARE: DEVON LOTKOWSKI 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	1-20-41081	CO

General Provider Information

NPI Number	:	1649861469
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DEVON LOTKOWSKI BCBA

Provider Business Mailing Address
First Line	:	7000 BROADWAY
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80221-2910
Country	:	US
Telephone Number	:	303-327-9738
Fax Number	:

Provider Business Practice Location Address
First Line	:	7000 BROADWAY
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80221-2910
Country	:	US
Telephone Number	:	303-327-9738
Fax Number	:

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

Provider Enumeration Date	:	02/03/2021
Last Update Date	:	02/03/2021

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