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NPI Code Detail

MEDICARE: ABIGAIL TATE

MEDICARE: ABIGAIL TATE
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 Technician
2106E00000XAssistant Behavior Analyst19310

General Provider Information

NPI Number : 1255082871
Entity Type Code : Individual
Provider Name (Legal Business Name) : ABIGAIL TATE
Provider Business Mailing Address
First Line : 1330 QUAIL LAKE LOOP STE 120
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80906-4651
Country : US
Telephone Number : 719-540-2108
Fax Number :
Provider Business Practice Location Address
First Line : 1330 QUAIL LAKE LOOP STE 120
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80906-4651
Country : US
Telephone Number : 719-540-2108
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/14/2022
Last Update Date : 12/10/2025

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Directions to “ ABIGAIL TATE ” Practice Location

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