Individual
EVANGELINA MAES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
820 ARRAWANNA CT, COLORADO SPRINGS, CO 80909-5203
(719) 367-3634
Mailing address
820 ARRAWANNA CT, COLORADO SPRINGS, CO 80909-5203
(719) 367-3634
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-22-203369
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1790211605
—
CO
Enumeration date
02/14/2022
Last updated
01/19/2023
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