Healthcare Provider Details

I. General information

NPI: 1871122903
Provider Name (Legal Business Name): DION FUTCH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/01/2020
Last Update Date: 03/07/2022
Certification Date: 02/17/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2636 S KING ST
DENVER CO
80219-5837
US

IV. Provider business mailing address

3940 W ANN RD STE 100
N LAS VEGAS NV
89031-3845
US

V. Phone/Fax

Practice location:
  • Phone: 720-688-1757
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-20-115572
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: