MEDICARE: TONI MARIE ANDERSEN

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		CO

General Provider Information

NPI Number	:	1972263283
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TONI MARIE ANDERSEN

Provider Business Mailing Address
First Line	:	8199 WELBY RD APT 4408
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80229-5660
Country	:	US
Telephone Number	:	425-221-4428
Fax Number	:

Provider Business Practice Location Address
First Line	:	8199 WELBY RD APT 4408
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80229-5660
Country	:	US
Telephone Number	:	425-221-4428
Fax Number	:

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

Provider Enumeration Date	:	12/28/2021
Last Update Date	:	12/28/2021

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Directions to “ TONI MARIE ANDERSEN ” Practice Location

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