MEDICARE: ABBY SAMANTHA HOPPER 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	:	1366055378
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ABBY SAMANTHA HOPPER RBT

Provider Business Mailing Address
First Line	:	1425 N UNION BLVD
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80909-2871
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1425 N UNION BLVD
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80909-2871
Country	:	US
Telephone Number	:	719-922-7906
Fax Number	:	720-367-5263

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

Provider Enumeration Date	:	08/28/2020
Last Update Date	:	12/09/2025

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