Healthcare Provider Details

I. General information

NPI: 1326950932
Provider Name (Legal Business Name): PALMA ENRIQUEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/18/2026
Last Update Date: 09/18/2026
Certification Date: 09/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6491 LANE 5 N
MOSCA CO
81146-9763
US

IV. Provider business mailing address

6491 LANE 5 N
MOSCA CO
81146-9763
US

V. Phone/Fax

Practice location:
  • Phone: 719-480-0848
  • Fax:
Mailing address:
  • Phone: 719-480-0848
  • Fax:

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: