Healthcare Provider Details

I. General information

NPI: 1255969663
Provider Name (Legal Business Name): STEPHANIE VOSS BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: STEPHANIE KIMMEN BCBA

II. Dates (important events)

Enumeration Date: 03/31/2020
Last Update Date: 06/25/2026
Certification Date: 06/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2205 MONTE VISTA ST
FORT LUPTON CO
80621-4654
US

IV. Provider business mailing address

2205 MONTE VISTA ST
FORT LUPTON CO
80621-4654
US

V. Phone/Fax

Practice location:
  • Phone: 909-362-1447
  • Fax:
Mailing address:
  • Phone: 909-362-1447
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT.17.41116
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-20-46327
License Number State
# 3
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-20-46327
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: