MEDICARE: JULIANA PLUCINIK

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	1-20-45409	CO
2	106E00000X	Assistant Behavior Analyst	0-20-11291	CO
3	106S00000X	Behavior Technician	RBT-18-65515	CO

General Provider Information

NPI Number	:	1134602279
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JULIANA PLUCINIK

Provider Business Mailing Address
First Line	:	1003 GILFIN CIR
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80915-2300
Country	:	US
Telephone Number	:	719-439-7170
Fax Number	:

Provider Business Practice Location Address
First Line	:	1003 GILFIN CIR
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80915-2300
Country	:	US
Telephone Number	:	719-439-7170
Fax Number	:	719-439-7170

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

Provider Enumeration Date	:	09/14/2018
Last Update Date	:	02/03/2026

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