Most Relevant Information
Provider Data
| NPI Number: | 1003377557 |
| Provider Name: | JENNIFER ANSELMO |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 03/27/2019 |
| Last Updated: | 11/10/2022 |
Provider Practice Location
6197 LEHMAN DR
SUITE 102
COLORADO SPRINGS
CO
809183437
Practice Location Phone/Fax
| Phone: | 3039898169 |
| Fax: |
Provider Mailing Location
6197 LEHMAN DR
SUITE 102
COLORADO SPRINGS
CO
809183437
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |