Individual
AMBER DAWN MIRACLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1300 N 17TH AVE, GREELEY, CO 80631-9584
(970) 397-8763
Mailing address
928 12TH ST, GREELEY, CO 80631-4024
(970) 397-8763
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
05/28/2021
Last updated
06/02/2021
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