| Soaring Eagles Center For Autism | |
|
125 W Palmer Lake Dr Pueblo West CO 81007-2876 | |
| (719) 547-8803 | |
| (719) 547-8806 |
| Full Name | Soaring Eagles Center For Autism |
|---|---|
| Speciality | Behavior Analyst |
| Location | 125 W Palmer Lake Dr, Pueblo West, Colorado |
| Authorized Official Name and Position | Karen W. Colvin-whitaker (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 7195478803 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Soaring Eagles Center For Autism Po Box 7878 Pueblo West CO 81007-0878 Ph: (719) 547-8803 | Soaring Eagles Center For Autism 125 W Palmer Lake Dr Pueblo West CO 81007-2876 Ph: (719) 547-8803 |
| NPI Number | 1851113732 |
|---|---|
| Provider Enumeration Date | 10/30/2024 |
| Last Update Date | 10/30/2024 |
| Certification Date | 10/30/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851113732 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
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