Healthcare Provider Details

I. General information

NPI: 1073452850
Provider Name (Legal Business Name): ASHLYN LAURA MYERS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/26/2026
Last Update Date: 03/26/2026
Certification Date: 03/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

685 CITADEL DR E STE 100
COLORADO SPRINGS CO
80909-5358
US

IV. Provider business mailing address

6450 BLACK RIDGE VW APT 108
COLORADO SPRINGS CO
80924-4454
US

V. Phone/Fax

Practice location:
  • Phone: 702-704-2300
  • Fax:
Mailing address:
  • Phone: 702-704-2300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: