Healthcare Provider Details

I. General information

NPI: 1730097510
Provider Name (Legal Business Name): ASHLEY ANNE PALOMERA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/31/2026
Last Update Date: 08/31/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17947 LAPIS CT
MONUMENT CO
80132-7801
US

IV. Provider business mailing address

4866 S OLD BROOK CIR
COLORADO SPRINGS CO
80917-1020
US

V. Phone/Fax

Practice location:
  • Phone: 719-301-9644
  • Fax:
Mailing address:
  • Phone: 661-699-6627
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number25467477
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: