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NPI Code Detail

MEDICARE: AUDREY GRACE SPIERS

MEDICARE:   AUDREY GRACE SPIERS
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
1106S00000XBehavior TechnicianCO

General Provider Information

NPI Number : 1235980483
Entity Type Code : Individual
Provider Name (Legal Business Name) : AUDREY GRACE SPIERS
Provider Business Mailing Address
First Line : 2120 E LASALLE ST
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80909-2218
Country : US
Telephone Number : 719-466-4809
Fax Number : 719-368-8399
Provider Business Practice Location Address
First Line : 1511 SWOPE AVE
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80909-2846
Country : US
Telephone Number : 719-466-4809
Fax Number : 719-368-8399
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/27/2024
Last Update Date : 03/27/2024

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Directions to “ AUDREY GRACE SPIERS ” Practice Location

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