Provider Demographics
NPI:1295193555
Name:GROEN, ANNETTE D (PHD, BCBA)
Entity Type:Individual
Prefix:DR
First Name:ANNETTE
Middle Name:D
Last Name:GROEN
Suffix:
Gender:F
Credentials:PHD, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10671 TIMBERDASH AVE
Mailing Address - Street 2:
Mailing Address - City:HIGHLANDS RANCH
Mailing Address - State:CO
Mailing Address - Zip Code:80126-5733
Mailing Address - Country:US
Mailing Address - Phone:303-249-2508
Mailing Address - Fax:
Practice Address - Street 1:10671 TIMBERDASH AVE
Practice Address - Street 2:
Practice Address - City:HIGHLANDS RANCH
Practice Address - State:CO
Practice Address - Zip Code:80126-5733
Practice Address - Country:US
Practice Address - Phone:303-249-2508
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-02-02
Last Update Date:2016-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1-15-20955103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst