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NPI 1164196176

NPI 1164196176 : ABIGAIL KERN MORSICATO BCBA : LAKEWOOD, CO

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General NPI Number Information
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    NPI Number           |    1164196176
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    Entity Type          |    Individual 
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    Provider Name        |    ABIGAIL KERN MORSICATO BCBA
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    08/03/2021
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    Last Update Date     |    05/23/2024
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Provider Practice Location Address
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    Address Line         |    11177 W 8TH AVE 
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    City                 |    LAKEWOOD
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    State                |    CO
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    Zip                  |    80215-5575
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    Country              |    US
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    Telephone            |    303-233-3633
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    1309 OAK WAY AVE 
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    City                 |    GLENWOOD SPRINGS
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    State                |    CO
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    Zip                  |    81601-4049
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    Country              |    US
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    Telephone            |    
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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        |    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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Taxonomy #2
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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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Taxonomy #3
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    Taxonomy Code        |    103K00000X
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    Taxonomy Name        |    Behavior Analyst
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    License Number       |    1-21-54945
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    License Number State |    CO
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