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NPI Code Detail

MEDICARE: SANDRA RUVALCABA M.A., BACB

MEDICARE: SANDRA RUVALCABA M.A., BACB
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
1174400000XSpecialist1084661CO
2103K00000XBehavior Analyst1084661CO

General Provider Information

NPI Number : 1992941595
Entity Type Code : Individual
Provider Name (Legal Business Name) : SANDRA RUVALCABA M.A., BACB
Provider Business Mailing Address
First Line : 2760 FIELDSTONE RD
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80919-3100
Country : US
Telephone Number : 719-203-6903
Fax Number : 719-203-6904
Provider Business Practice Location Address
First Line : 2760 FIELDSTONE RD
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80919-3100
Country : US
Telephone Number : 719-203-6903
Fax Number : 719-203-6904
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/02/2009
Last Update Date : 05/09/2017

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