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NPI Code Detail

MEDICARE: ELIZABETH OSTENDORF LLC

MEDICARE: ELIZABETH OSTENDORF LLC
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
1106E00000XAssistant Behavior Analyst
2106S00000XBehavior Technician
3103K00000XBehavior Analyst

General Provider Information

NPI Number : 1346815099
Entity Type Code : Organization
Provider Name (Legal Business Name) : ELIZABETH OSTENDORF LLC
Provider Business Mailing Address
First Line : 2120 E LA SALLE ST
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80909-2218
Country : US
Telephone Number : 719-466-4809
Fax Number :
Provider Business Practice Location Address
First Line : 5910 GALLEY RD
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80915-3736
Country : US
Telephone Number : 719-309-0119
Fax Number : 719-368-8399
Authorized Official
Title or Position : CEO
Name : ELIZABETH MARY OSTENDORF
Credential :
Telephone Number : 719-649-5037
Provider Enumeration Date : 05/25/2021
Last Update Date : 11/04/2024

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Directions to “ELIZABETH OSTENDORF LLC ” Practice Location

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