Healthcare Provider Details

I. General information

NPI: 1952824088
Provider Name (Legal Business Name): DANIEL A WITTLE M.ED., BCBA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/20/2017
Last Update Date: 07/20/2026
Certification Date: 07/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3401 QUEBEC ST # 110
DENVER CO
80207-2322
US

IV. Provider business mailing address

3401 QUEBEC ST # 110
DENVER CO
80207-2322
US

V. Phone/Fax

Practice location:
  • Phone: 720-706-3396
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License NumberBACB294054
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: