Healthcare Provider Details

I. General information

NPI: 1033048806
Provider Name (Legal Business Name): MISS JESSENIA ALEXANDRA LIMON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/18/2026
Last Update Date: 05/18/2026
Certification Date: 05/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1050 S ACADEMY BLVD STE 140
COLORADO SPRINGS CO
80910-3922
US

IV. Provider business mailing address

5804 DAKAN LOOP
COLORADO SPRINGS CO
80927-4255
US

V. Phone/Fax

Practice location:
  • Phone: 888-754-0398
  • Fax: 954-982-6491
Mailing address:
  • Phone: 888-754-0398
  • Fax: 954-982-6491

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number04132006
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: