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Individual

CHANTE BALDWIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1079 SPACE CENTER DR, COLORADO SPRINGS, CO 80915-3612
(888) 745-0398
Mailing address
7362 LITTLE JIMMY GRV, FOUNTAIN, CO 80817-4270

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2105226336
LICENSE NUMBER
NV
Enumeration date
11/07/2022
Last updated
11/07/2022
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