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NPI Code Detail

MEDICARE: EMILY RETTING RBT

MEDICARE: EMILY RETTING RBT
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-18-48559CO

General Provider Information

NPI Number : 1952802886
Entity Type Code : Individual
Provider Name (Legal Business Name) : EMILY RETTING RBT
Provider Business Mailing Address
First Line : 4815 LIST DR STE 107
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80919-3340
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4815 LIST DR STE 107
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80919-3340
Country : US
Telephone Number : 719-649-5037
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/26/2018
Last Update Date : 02/26/2018

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Directions to “ EMILY RETTING RBT” Practice Location

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