Provider Demographics
NPI:1992431092
Name:SPAULDING, KAMRI TAYLOR
Entity type:Individual
Prefix:
First Name:KAMRI
Middle Name:TAYLOR
Last Name:SPAULDING
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:107 W CHEYENNE RD APT 101
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80906-2505
Mailing Address - Country:US
Mailing Address - Phone:325-500-8881
Mailing Address - Fax:
Practice Address - Street 1:107 W CHEYENNE RD APT 101
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80906-2505
Practice Address - Country:US
Practice Address - Phone:325-500-8881
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-29
Last Update Date:2023-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RBT-22-226669106S00000X, 106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician