Individual
EMILY ROSE DICROCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
10713 FILLMORE CT, NORTHGLENN, CO 80233-4628
(720) 923-1866
Mailing address
10713 FILLMORE CT, NORTHGLENN, CO 80233-4628
(720) 923-1866
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
00000000000000
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
XFW197M98790
ANTHEM BLUE CROSS
CO
Enumeration date
04/02/2019
Last updated
04/02/2019
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