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NPI Code Detail

MEDICARE: ASHLEY LYNN COFFEY

MEDICARE: ASHLEY LYNN COFFEY
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
1106S00000XBehavior Technician19-102136CO

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1619513116
Entity Type Code : Individual
Provider Name (Legal Business Name) : ASHLEY LYNN COFFEY
Provider Business Mailing Address
First Line : 4732 SEBRING DR
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80911-3636
Country : US
Telephone Number : 254-258-1697
Fax Number :
Provider Business Practice Location Address
First Line : 1915 AEROTECH DR STE 190
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80916-4213
Country : US
Telephone Number : 719-301-5100
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/20/2019
Last Update Date : 11/20/2019

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Directions to “ ASHLEY LYNN COFFEY ” Practice Location

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