Individual
KATELYN GRUBER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MED., BCBA
Contact information
Practice address
6795 E TENNESSEE AVE STE 427, DENVER, CO 80224-1699
(303) 564-0751
Mailing address
275 S CHEROKEE ST APT 3409, DENVER, CO 80223-1955
(703) 340-4900
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-21-49119
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
BACB456565
BACB
—
Enumeration date
09/08/2020
Last updated
04/24/2021
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