Individual
KEVIN CARBON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BCBA
Contact information
Practice address
57 N MISSION DR, PUEBLO, CO 81007-1425
(719) 504-4004
Mailing address
57 N MISSION DR, PUEBLO, CO 81007-1425
(719) 504-4004
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-21-56408
CO
106S00000X
Behavior Technician
—
—
Other
Enumeration date
04/17/2019
Last updated
03/15/2022
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