Healthcare Provider Details

I. General information

NPI: 1013638246
Provider Name (Legal Business Name): JAMIE CHRISTEN WOLFGANG MS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/06/2022
Last Update Date: 04/27/2026
Certification Date: 04/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

408 VICTORIA AVE
ALAMOSA CO
81101-4207
US

IV. Provider business mailing address

10650 E BETHANY DR
AURORA CO
80014-2653
US

V. Phone/Fax

Practice location:
  • Phone: 720-584-8055
  • Fax:
Mailing address:
  • Phone: 720-584-8055
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-25-80345
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: