Individual
ALEXANDRIA CARBAJAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
319 MOUNT VIEW LN, FOUNTAIN, CO 80817-1727
(719) 424-6472
Mailing address
319 MOUNT VIEW LN, FOUNTAIN, CO 80817-1727
(719) 424-6472
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-23-252556
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1790211605
—
CO
Enumeration date
10/17/2022
Last updated
01/23/2023
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