Provider Demographics
NPI:1679934533
Name:GFELLER, HANNAH (BCBA)
Entity Type:Individual
Prefix:
First Name:HANNAH
Middle Name:
Last Name:GFELLER
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:HANNAH
Other - Middle Name:
Other - Last Name:BLAHA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BCBA
Mailing Address - Street 1:6204 TWIN OAKS DR
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80918
Mailing Address - Country:US
Mailing Address - Phone:323-426-6245
Mailing Address - Fax:
Practice Address - Street 1:6204 TWIN OAKS DR
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80918
Practice Address - Country:US
Practice Address - Phone:323-426-6245
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-18
Last Update Date:2022-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103K00000X
CA1-15-21255103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty