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NPI Code Detail

MEDICARE: KIMBERLY HENRY

MEDICARE: KIMBERLY HENRY
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 Analyst1-22-58593CO

General Provider Information

NPI Number : 1700488442
Entity Type Code : Individual
Provider Name (Legal Business Name) : KIMBERLY HENRY
Provider Business Mailing Address
First Line : 2212 N CHELTON RD
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80909-1410
Country : US
Telephone Number : 719-209-1763
Fax Number :
Provider Business Practice Location Address
First Line : 6190 BARNES RD
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80922-2600
Country : US
Telephone Number : 719-597-0822
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/09/2020
Last Update Date : 03/26/2026

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Directions to “ KIMBERLY HENRY ” Practice Location

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