Healthcare Provider Details

I. General information

NPI: 1073172011
Provider Name (Legal Business Name): HOPE ROSE BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/12/2019
Last Update Date: 12/22/2025
Certification Date: 12/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7200 S ALTON WAY STE A100
CENTENNIAL CO
80112-2207
US

IV. Provider business mailing address

637 S 40TH ST
BOULDER CO
80305-5904
US

V. Phone/Fax

Practice location:
  • Phone: 303-945-7063
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-23-69401
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: