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Individual

MILTON BRET MIXON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
BCBA, CCC-SLP

Contact information

Practice address
395 RIDGES BLVD, GRAND JUNCTION, CO 81507-4630
(970) 812-3828
(970) 807-0765
Mailing address
395 RIDGES BLVD, GRAND JUNCTION, CO 81507-4630
(970) 812-3828
(970) 807-0765

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
235Z00000X
Speech-Language Pathologist

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
9000167646
CO
01
SLP.0001198
STATE LICENSE
CO
Enumeration date
05/31/2007
Last updated
04/25/2025
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