Healthcare Provider Details

I. General information

NPI: 1467928531
Provider Name (Legal Business Name): KELLY ZILINSKAS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/16/2018
Last Update Date: 01/20/2023
Certification Date: 01/20/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7220 W JEFFERSON AVE STE 100
LAKEWOOD CO
80235-2015
US

IV. Provider business mailing address

1025 PACIFIC HILLS PT
COLORADO SPRINGS CO
80906-8442
US

V. Phone/Fax

Practice location:
  • Phone: 303-225-7673
  • Fax:
Mailing address:
  • Phone: 708-728-5033
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-20-46663
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-20-44803
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: