Individual
AMANDA MARIE VAN DERBUR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
901 N SANTA FE AVE, FOUNTAIN, CO 80817-1738
(719) 822-0550
Mailing address
3625 CITADEL DR S, COLORADO SPRINGS, CO 80909-5320
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
09/14/2023
Last updated
09/14/2023
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