Healthcare Provider Details

I. General information

NPI: 1114412814
Provider Name (Legal Business Name): MEGHAN SARGENT RBT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/25/2018
Last Update Date: 06/25/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9900 E ILIFF AVE
DENVER CO
80231-3462
US

IV. Provider business mailing address

9653 E 5TH AVE APT 11-303
DENVER CO
80230-7290
US

V. Phone/Fax

Practice location:
  • Phone: 303-636-5600
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-18-47430
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: