Healthcare Provider Details

I. General information

NPI: 1124948302
Provider Name (Legal Business Name): ALISHA DIANNE ROGERS RBT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/17/2026
Last Update Date: 07/17/2026
Certification Date: 07/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6203 S LEMAY AVE
FORT COLLINS CO
80525-9436
US

IV. Provider business mailing address

4019 DENVER ST
EVANS CO
80620-2929
US

V. Phone/Fax

Practice location:
  • Phone: 720-295-3790
  • Fax: 877-400-4480
Mailing address:
  • Phone: 720-295-3790
  • Fax: 877-400-4480

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: