Healthcare Provider Details

I. General information

NPI: 1528541760
Provider Name (Legal Business Name): SARA ELIZABETH ECHELBERGER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/13/2018
Last Update Date: 09/13/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12650 E BRIARWOOD AVE UNIT 207
CENTENNIAL CO
80112-6792
US

IV. Provider business mailing address

3512 S JASPER WAY
AURORA CO
80013-2429
US

V. Phone/Fax

Practice location:
  • Phone: 720-470-0578
  • Fax:
Mailing address:
  • Phone: 720-988-0259
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: