Healthcare Provider Details

I. General information

NPI: 1134094600
Provider Name (Legal Business Name): ALICE FRESKE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/06/2025
Last Update Date: 08/14/2026
Certification Date: 08/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11550 SHERIDAN BLVD
WESTMINSTER CO
80020-3311
US

IV. Provider business mailing address

13241 PEARL ST
THORNTON CO
80241-1744
US

V. Phone/Fax

Practice location:
  • Phone: 720-355-6049
  • Fax:
Mailing address:
  • Phone: 720-355-6049
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-26-91039
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: