Individual
GENEVA NIRIAH BYNUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2233 ACADEMY PL SHANDY CLINIC- ACADEMY PLACE, SUITE 200, SPRINGS, CO 80909
(719) 301-0002
Mailing address
2233 ACADEMY PL STE 200, COLORADO SPRINGS, CO 80909-1666
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
08/11/2022
Last updated
08/11/2022
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