MEDICARE: MRS. MARICELA ACEVEDO BCBA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103K00000X	Behavior Analyst	1-10-6958

General Provider Information

NPI Number	:	1043515950
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MARICELA ACEVEDO BCBA

Provider Business Mailing Address
First Line	:	7200 E DRY CREEK RD
Second Line	:	E104
City	:	CENTENNIAL
State	:	CO
Zip	:	80112-2537
Country	:	US
Telephone Number	:	866-300-0822
Fax Number	:	303-600-9933

Provider Business Practice Location Address
First Line	:	7200 E DRY CREEK RD
Second Line	:	E104
City	:	CENTENNIAL
State	:	CO
Zip	:	80112-2537
Country	:	US
Telephone Number	:	866-300-0822
Fax Number	:	303-600-9933

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/24/2011
Last Update Date	:	05/19/2021

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