Provider Demographics
NPI:1134958283
Name:BLUBAUGH, ZOE (BCBA)
Entity type:Individual
Prefix:
First Name:ZOE
Middle Name:
Last Name:BLUBAUGH
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 1:6950 W 109TH AVE APT 206
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:CO
Mailing Address - Zip Code:80020-1694
Mailing Address - Country:US
Mailing Address - Phone:704-439-6628
Mailing Address - Fax:
Practice Address - Street 1:3120 IRVING ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80211-3632
Practice Address - Country:US
Practice Address - Phone:720-355-1081
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-29
Last Update Date:2024-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1-24-74202103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst