Healthcare Provider Details

I. General information

NPI: 1699385575
Provider Name (Legal Business Name): NAOMI MEGELSH RBT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/05/2020
Last Update Date: 08/05/2020
Certification Date: 08/05/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8002 E 50TH DR
DENVER CO
80238-3299
US

IV. Provider business mailing address

8002 E 50TH DR
DENVER CO
80238-3299
US

V. Phone/Fax

Practice location:
  • Phone: 720-961-3764
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-19-91505
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: