MEDICARE: ROMA GRACE VELASCO

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	103K00000X	Behavior Analyst	1-26-89445	CO

General Provider Information

NPI Number	:	1528904497
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROMA GRACE VELASCO

Provider Business Mailing Address
First Line	:	685 BRIGGS ST
Second Line	:
City	:	ERIE
State	:	CO
Zip	:	80516-5022
Country	:	US
Telephone Number	:	720-849-2668
Fax Number	:

Provider Business Practice Location Address
First Line	:	685 BRIGGS ST
Second Line	:
City	:	ERIE
State	:	CO
Zip	:	80516-5022
Country	:	US
Telephone Number	:	720-849-2668
Fax Number	:

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

Provider Enumeration Date	:	04/24/2026
Last Update Date	:	04/24/2026

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Directions to “ ROMA GRACE VELASCO ” Practice Location

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