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General NPI Number Information
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NPI Number | 1922695519
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Entity Type | Individual
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Provider Name | EILIS MCGOVERN BCBA
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Gender | Female
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Dates
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Enumeration Date | 12/29/2020
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Last Update Date | 07/03/2025
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Provider Practice Location Address
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Address Line | 620 MAIN ST UNIT 9
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City | FRISCO
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State | CO
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Zip | 80443-5487
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Country | US
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Telephone | 719-839-0552
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Fax |
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Provider Business Mailing Address
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Address Line | 412C BAYVIEW DR # 355
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City | FRISCO
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State | CO
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Zip | 80443-5179
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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 | 1-20-45646
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License Number State | CO
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