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Nathaniel Lee Edison

Behavior Technician in Thornton, CO. Individual provider (NPI-1).

NPI number1982202198
StatusActive
Last updated in NPPESOct 12, 2020

Details

NPI
1982202198
Entity type
Individual (NPI-1)
Name
Nathaniel Lee Edison
Sex
Male
Sole proprietor
Yes
Enumeration date
Oct 12, 2020
Certification date
Oct 12, 2020
Last updated
Oct 12, 2020

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
106S00000X Behavior Technician––Yes

Practice location

14548 High St
Thornton, CO 80602-7005

Phone 941-504-4180

Mailing address

14548 High St
Thornton, CO 80602-7005

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