Individual
ELIJAH ABENDROTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1915 AEROTECH DR STE 180, COLORADO SPRINGS, CO 80916-4213
(719) 301-5100
Mailing address
1915 AEROTECH DR STE 180, COLORADO SPRINGS, CO 80916-4213
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-20-113384
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1790211605
—
CO
Enumeration date
02/25/2020
Last updated
02/25/2020
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