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NPI Code Detail

MEDICARE: SOPHIE C VAIL BCBA

MEDICARE: SOPHIE C VAIL 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 Analyst

General Provider Information

NPI Number : 1912471079
Entity Type Code : Individual
Provider Name (Legal Business Name) : SOPHIE C VAIL BCBA
Provider Business Mailing Address
First Line : 1309 OAK WAY AVE
Second Line :
City : GLENWOOD SPRINGS
State : CO
Zip : 81601-4049
Country : US
Telephone Number : 720-670-9046
Fax Number : 720-294-0543
Provider Business Practice Location Address
First Line : 1309 OAK WAY AVE
Second Line :
City : GLENWOOD SPRINGS
State : CO
Zip : 81601-4049
Country : US
Telephone Number : 720-670-9046
Fax Number : 720-294-0543
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/11/2019
Last Update Date : 01/11/2019

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Directions to “ SOPHIE C VAIL BCBA” Practice Location

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