Healthcare Provider Details

I. General information

NPI: 1902313422
Provider Name (Legal Business Name): CHRISTOPHER KIM RBT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/05/2018
Last Update Date: 05/19/2026
Certification Date: 05/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19585 HESS RD UNIT 106
PARKER CO
80134-3892
US

IV. Provider business mailing address

19585 HESS RD UNIT 106
PARKER CO
80134-3892
US

V. Phone/Fax

Practice location:
  • Phone: 720-642-7019
  • Fax:
Mailing address:
  • Phone: 720-642-7019
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-26-89835
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number17-29975
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: