Provider Demographics
NPI:1083172373
Name:BALDASSARI, ANTHONY (BCBA)
Entity type:Individual
Prefix:
First Name:ANTHONY
Middle Name:
Last Name:BALDASSARI
Suffix:
Gender:M
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10700 E GEDDES AVE STE 125
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80112
Mailing Address - Country:US
Mailing Address - Phone:720-797-6155
Mailing Address - Fax:720-294-0543
Practice Address - Street 1:10700 E GEDDES AVE STE 125
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80112
Practice Address - Country:US
Practice Address - Phone:720-797-6155
Practice Address - Fax:720-294-0543
Is Sole Proprietor?:No
Enumeration Date:2019-03-06
Last Update Date:2024-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst