Provider Demographics
NPI:1972844777
Name:HARRIS-SHOFFNER, CAIA (BCBA)
Entity Type:Individual
Prefix:
First Name:CAIA
Middle Name:
Last Name:HARRIS-SHOFFNER
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 1:731 N WAHSATCH AVE
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80903-3005
Mailing Address - Country:US
Mailing Address - Phone:719-649-8174
Mailing Address - Fax:
Practice Address - Street 1:6385 CORPORATE DR STE 301
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80919-5913
Practice Address - Country:US
Practice Address - Phone:719-380-1100
Practice Address - Fax:719-203-6904
Is Sole Proprietor?:No
Enumeration Date:2013-03-05
Last Update Date:2021-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0135260103K00000X
CO1-17-26811103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst