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NPI Code Detail

MEDICARE: MRS. REBECCA ELIZABETH URBANO POWELL BCBA

MEDICARE: MRS. REBECCA ELIZABETH URBANO POWELL 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
1103K00000XBehavior Analyst1-14-15258CA

General Provider Information

NPI Number : 1194120477
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. REBECCA ELIZABETH URBANO POWELL BCBA
Provider Business Mailing Address
First Line : 3155 SNOW TRILLIUM WAY
Second Line :
City : EVERGREEN
State : CO
Zip : 80439-9204
Country : US
Telephone Number : 720-295-7290
Fax Number : 877-400-4480
Provider Business Practice Location Address
First Line : 1035 EL RANCHO RD
Second Line :
City : EVERGREEN
State : CO
Zip : 80439-8238
Country : US
Telephone Number : 720-295-3790
Fax Number : 877-400-4480
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/28/2014
Last Update Date : 11/07/2022

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