Individual
SYMONE A ROQUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
245 S ACADEMY BLVD, COLORADO SPRINGS, CO 80910-2713
(719) 224-7108
Mailing address
245 S ACADEMY BLVD, COLORADO SPRINGS, CO 80910-2713
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-24-74201
CO
106S00000X
Behavior Technician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
46730061
—
CO
Enumeration date
07/10/2019
Last updated
07/29/2024
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