Healthcare Provider Details

I. General information

NPI: 1386579068
Provider Name (Legal Business Name): ANDREW BRYAN FORSLAND
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/15/2026
Last Update Date: 06/15/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8000 E GIRARD AVE APT 219
DENVER CO
80231-4404
US

IV. Provider business mailing address

8000 E GIRARD AVE APT 219
DENVER CO
80231-4404
US

V. Phone/Fax

Practice location:
  • Phone: 702-908-5933
  • Fax:
Mailing address:
  • Phone: 702-908-5933
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-25-504066
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: