Healthcare Provider Details

I. General information

NPI: 1003465766
Provider Name (Legal Business Name): SARAH REESE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/05/2019
Last Update Date: 09/12/2023
Certification Date: 09/12/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

34 SOUTH SELIG AVENUE
MONTROSE CO
81401
US

IV. Provider business mailing address

10650 E BETHANY DRIVE
AURORA CO
80014
US

V. Phone/Fax

Practice location:
  • Phone: 719-466-4809
  • Fax:
Mailing address:
  • Phone: 720-272-1289
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number19-95681
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: