Basic Information
| Provider Information | |||||||||
| NPI: | 1750994133 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ELMER | ||||||||
| FirstName: | RYANN | ||||||||
| MiddleName: | ESCOCHEA | ||||||||
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| Credential: | BCBA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1560 BOULDER ST UNIT 208 | ||||||||
| Address2: | |||||||||
| City: | DENVER | ||||||||
| State: | CO | ||||||||
| PostalCode: | 802116009 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8322068569 | ||||||||
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| Practice Location | |||||||||
| Address1: | 12650 E BRIARWOOD AVE UNIT 207 | ||||||||
| Address2: | |||||||||
| City: | CENTENNIAL | ||||||||
| State: | CO | ||||||||
| PostalCode: | 801126792 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7204700578 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/26/2020 | ||||||||
| LastUpdateDate: | 08/26/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/26/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103K00000X | Y | Behavioral Health & Social Service Providers | Behavioral Analyst |
No ID Information.