Individual
AVA CHRISTINE COOREMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RBT
Contact information
Practice address
KEYSTONE CENTRAL 5526 N. ACADEMY BLVD. STE 109, COLORADO SPRINGS, CO 80918
(719) 301-5100
Mailing address
KEYSTONE CENTRAL 5526 N. ACADEMY BLVD. STE 109, COLORADO SPRINGS, CO 80918
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
171100432
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1790211605
—
CO
Enumeration date
02/08/2024
Last updated
02/08/2024
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