Most Relevant Information
Provider Data
| NPI Number: | 1003684689 |
| Provider Name: | EVANGELINE ACCORNERO RBT |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: | RBT-23-316422 |
Most Important Dates
| Enumeration Date: | 12/13/2023 |
| Last Updated: | 12/13/2023 |
Provider Practice Location
245 S ACADEMY BLVD
COLORADO SPRINGS
CO
809102713
Practice Location Phone/Fax
| Phone: | 7192247108 |
| Fax: |
Provider Mailing Location
245 S ACADEMY BLVD
COLORADO SPRINGS
CO
809102713
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |