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NPI Code Detail

MEDICARE: NICHOLAS MATTHEW BOWLAND M. ED.

MEDICARE: NICHOLAS MATTHEW BOWLAND M. ED.
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 TechnicianRBT-22-231477CO
2103K00000XBehavior Analyst1-22-63268CO

General Provider Information

NPI Number : 1871037895
Entity Type Code : Individual
Provider Name (Legal Business Name) : NICHOLAS MATTHEW BOWLAND M. ED.
Provider Business Mailing Address
First Line : 2001 HOYT ST
Second Line :
City : LAKEWOOD
State : CO
Zip : 80215-1639
Country : US
Telephone Number : 303-759-1192
Fax Number :
Provider Business Practice Location Address
First Line : 2020 W COLORADO AVE STE 101A
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80904-3863
Country : US
Telephone Number : 602-358-4339
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/09/2016
Last Update Date : 03/01/2023

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Directions to “ NICHOLAS MATTHEW BOWLAND M. ED.” Practice Location

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