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NPI Code Detail

MEDICARE: RAKEM DASHAWN LEVERETTE

MEDICARE: RAKEM DASHAWN LEVERETTE
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
1103K00000XBehavior AnalystCO

General Provider Information

NPI Number : 1053951335
Entity Type Code : Individual
Provider Name (Legal Business Name) : RAKEM DASHAWN LEVERETTE
Provider Business Mailing Address
First Line : 5910 GALLEY RD
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80915-3736
Country : US
Telephone Number : 719-466-4809
Fax Number :
Provider Business Practice Location Address
First Line : 5910 GALLEY RD
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80915-3736
Country : US
Telephone Number : 719-466-4809
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/14/2020
Last Update Date : 09/17/2025

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Directions to “ RAKEM DASHAWN LEVERETTE ” Practice Location

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