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NPI Code Detail

MEDICARE: MAGDALENA PYRTEK SMITH BCBA

MEDICARE: MAGDALENA PYRTEK SMITH BCBA
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 Analyst1-10-7166CO

General Provider Information

NPI Number : 1568728772
Entity Type Code : Individual
Provider Name (Legal Business Name) : MAGDALENA PYRTEK SMITH BCBA
Provider Business Mailing Address
First Line : 265 S HARLAN ST
Second Line :
City : LAKEWOOD
State : CO
Zip : 80226-2261
Country : US
Telephone Number : 720-272-1289
Fax Number :
Provider Business Practice Location Address
First Line : 265 S HARLAN ST
Second Line :
City : LAKEWOOD
State : CO
Zip : 80226-2261
Country : US
Telephone Number : 720-272-1289
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/02/2012
Last Update Date : 03/25/2013

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