MEDICARE: MARCI BOWEN RBT

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	106S00000X	Behavior Technician

General Provider Information

NPI Number	:	1275091431
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARCI BOWEN RBT

Provider Business Mailing Address
First Line	:	7150 CAMPUS DR
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80920-3177
Country	:	US
Telephone Number	:	719-538-5600
Fax Number	:

Provider Business Practice Location Address
First Line	:	7150 CAMPUS DR
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80920-3177
Country	:	US
Telephone Number	:	719-538-5600
Fax Number	:

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

Provider Enumeration Date	:	03/06/2019
Last Update Date	:	03/06/2019

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Directions to “ MARCI BOWEN RBT” Practice Location

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