Healthcare Provider Details

I. General information

NPI: 1467943084
Provider Name (Legal Business Name): MELANIE AGUILAR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/21/2018
Last Update Date: 06/07/2026
Certification Date: 06/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6855 S HAVANA ST
CENTENNIAL CO
80112-3837
US

IV. Provider business mailing address

2939 S GALAPAGO ST UNIT 5106
ENGLEWOOD CO
80110-1548
US

V. Phone/Fax

Practice location:
  • Phone: 720-896-4146
  • Fax:
Mailing address:
  • Phone: 808-349-5219
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-26-89551
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: