Healthcare Provider Details
I. General information
NPI: 1780595819
Provider Name (Legal Business Name): MIKEALLA ASHLYN SANCHEZ RBT
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 09/16/2026
Last Update Date: 09/16/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
701 SH-59
YUMA CO
80759
US
IV. Provider business mailing address
603 N MAIN ST APT B
YUMA CO
80759-1424
US
V. Phone/Fax
- Phone: 720-272-1289
- Fax:
- Phone: 720-272-1289
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 106S00000X |
| Taxonomy | Behavior Technician |
| License Number | |
| License Number State | CO |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: