Organization
CLEAR CREEK BEHAVIOR SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAMELA MARTIEN-KOCH (OWNER)
(303) 912-9976
Entity
Organization
Contact information
Practice address
214 EAGLE DR, GOLDEN, CO 80403-7768
(303) 912-9976
Mailing address
214 EAGLE DR, GOLDEN, CO 80403-7768
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-04-1944
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9000143403
—
CO
Enumeration date
08/06/2017
Last updated
08/06/2017
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