Individual
ANGELE TATEM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BCABA
Contact information
Practice address
29374 GREENWOOD LN, EVERGREEN, CO 80439-7404
(303) 907-1449
Mailing address
PO BOX 548, EVERGREEN, CO 80437-0548
(303) 907-1449
Taxonomy
Speciality
Code
Description
License number
State
106E00000X
Assistant Behavior Analyst
Primary
0-11-4361
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0-11-4361
BOARD CERTIFICATION FOR BEHAVIOR ANALYSIS
—
Enumeration date
06/20/2017
Last updated
06/20/2017
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