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Individual

GILBERT FAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
685 CITADEL DR E, COLORADO SPRINGS, CO 80909-5314
(719) 298-3476
Mailing address
2144 BABBLING STREAM HTS, COLORADO SPRINGS, CO 80910-3018

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-25-435781

Other

Enumeration date
07/24/2025
Last updated
07/24/2025
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