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General NPI Number Information
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NPI Number | 1053223941
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Entity Type | Individual
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Provider Name | MR. GAGE SPENCER MULLINS
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Gender | Male
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Dates
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Enumeration Date | 09/17/2026
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Last Update Date | 09/17/2026
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Provider Practice Location Address
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Address Line | 720 S COLORADO BLVD #NORTH
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City | DENVER
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State | CO
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Zip | 80246-1904
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Country | US
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Telephone | 720-440-8036
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Fax |
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Provider Business Mailing Address
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Address Line | 99 S BROADWAY APT 130
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City | DENVER
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State | CO
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Zip | 80209-1789
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Country | US
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Telephone | 708-476-0221
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number | RBT-25-420774
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License Number State | CO
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