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General NPI Number Information
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NPI Number | 1033020342
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Entity Type | Organization
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Legal Business Name | BISON CIRCLE COLLABORATIVE
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Dates
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Enumeration Date | 09/15/2026
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Last Update Date | 09/15/2026
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Provider Practice Location Address
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Address Line | 15 S 33RD ST
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City | BOULDER
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State | CO
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Zip | 80305-3423
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Country | US
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Telephone | 720-235-8036
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Fax |
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Provider Business Mailing Address
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Address Line | 1500 N GRANT ST # 11592
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City | DENVER
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State | CO
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Zip | 80203-1859
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Country | US
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Telephone | 720-235-8036
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Fax |
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | RAYL SMITH
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Credential | MS, BCBA
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Telephone | 541-941-4392
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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