Provider Demographics
NPI:1518694363
Name:MACKE, MAIGA (BCBA)
Entity Type:Individual
Prefix:
First Name:MAIGA
Middle Name:
Last Name:MACKE
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 1:835 S LILAC ST
Mailing Address - Street 2:
Mailing Address - City:MILLIKEN
Mailing Address - State:CO
Mailing Address - Zip Code:80543-9475
Mailing Address - Country:US
Mailing Address - Phone:303-895-5877
Mailing Address - Fax:
Practice Address - Street 1:3780 N GARFIELD AVE
Practice Address - Street 2:
Practice Address - City:LOVELAND
Practice Address - State:CO
Practice Address - Zip Code:80538-2233
Practice Address - Country:US
Practice Address - Phone:970-966-3522
Practice Address - Fax:970-775-2840
Is Sole Proprietor?:No
Enumeration Date:2022-08-02
Last Update Date:2022-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1-22-60514103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst