Provider Demographics
NPI:1316484140
Name:BOLLINGER, DELEIGN (BCBA)
Entity type:Individual
Prefix:
First Name:DELEIGN
Middle Name:
Last Name:BOLLINGER
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:685 CITADEL DR E STE 345
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80909-5326
Mailing Address - Country:US
Mailing Address - Phone:940-968-7105
Mailing Address - Fax:
Practice Address - Street 1:685 CITADEL DR E STE 345
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80909-5326
Practice Address - Country:US
Practice Address - Phone:719-540-2108
Practice Address - Fax:719-540-2101
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-31
Last Update Date:2017-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1-16-24721103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst