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General NPI Number Information
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NPI Number | 1114827821
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Entity Type | Individual
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Provider Name | KATY RUTH DEACON
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Gender | Female
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Dates
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Enumeration Date | 11/07/2026
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Last Update Date | 11/07/2026
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Provider Practice Location Address
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Address Line | 6312 S FIDDLERS GREEN CIR STE 30
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City | GREENWOOD VILLAGE
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State | CO
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Zip | 80111-4943
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Country | US
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Telephone | 385-231-1397
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Fax |
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Provider Business Mailing Address
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Address Line | 3761 75TH ST
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City | BOULDER
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State | CO
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Zip | 80301-4518
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Country | US
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Telephone | 385-494-3500
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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 |
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License Number State |
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