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Individual

MICHELLE FAZEKAS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
BCBA

Contact information

Practice address
4284 TRAIL BOSS DR STE 110, CASTLE ROCK, CO 80104-7521
(406) 546-1108
Mailing address
723 SPARROW HAWK DR, HIGHLANDS RANCH, CO 80129-6920
(406) 546-1108

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-20-46586
CO
103K00000X
Behavior Analyst

Other

Enumeration date
10/03/2017
Last updated
03/06/2023
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