Provider Demographics
NPI:1376396796
Name:ALLEN, KARLY C (RBT)
Entity Type:Individual
Prefix:
First Name:KARLY
Middle Name:C
Last Name:ALLEN
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:410 SYCAMORE AVE
Mailing Address - Street 2:
Mailing Address - City:JOHNSTOWN
Mailing Address - State:CO
Mailing Address - Zip Code:80534-9167
Mailing Address - Country:US
Mailing Address - Phone:720-217-3946
Mailing Address - Fax:
Practice Address - Street 1:3768 NORWOOD DR STE 200
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80125-9710
Practice Address - Country:US
Practice Address - Phone:720-491-8171
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-08
Last Update Date:2024-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CORBT-21-164757106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician