MEDICARE: ELIZABETH GIRAUD RBT-46844

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
1	106S00000X	Behavior Technician	17-46844	IL

General Provider Information

NPI Number	:	1942799457
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELIZABETH GIRAUD RBT-46844

Provider Business Mailing Address
First Line	:	1034 S WASHINGTON ST
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80209-4318
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1034 S WASHINGTON ST
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80209-4318
Country	:	US
Telephone Number	:	401-499-2600
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/09/2018
Last Update Date	:	05/09/2018

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