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NPI Code Detail

MEDICARE: DARRELL JANSEN

MEDICARE:   DARRELL  JANSEN
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 Analyst1-23-68560

General Provider Information

NPI Number : 1356903975
Entity Type Code : Individual
Provider Name (Legal Business Name) : DARRELL JANSEN
Provider Business Mailing Address
First Line : 4164 AUSTIN BLUFFS PKWY STE 221
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80918-2928
Country : US
Telephone Number : 719-728-5881
Fax Number :
Provider Business Practice Location Address
First Line : 8415 EXPLORER DR STE 130
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80920-1034
Country : US
Telephone Number : 719-900-5690
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/03/2019
Last Update Date : 09/08/2024

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Directions to “ DARRELL JANSEN ” Practice Location

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