Provider Demographics
NPI:1205354081
Name:COTTINGHAM, JILL (MA, BCBA)
Entity type:Individual
Prefix:
First Name:JILL
Middle Name:
Last Name:COTTINGHAM
Suffix:
Gender:F
Credentials:MA, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8345 POUDRE CANYON RD
Mailing Address - Street 2:
Mailing Address - City:BELLVUE
Mailing Address - State:CO
Mailing Address - Zip Code:80512-7405
Mailing Address - Country:US
Mailing Address - Phone:970-217-7736
Mailing Address - Fax:
Practice Address - Street 1:8345 POUDRE CANYON RD
Practice Address - Street 2:
Practice Address - City:BELLVUE
Practice Address - State:CO
Practice Address - Zip Code:80512-7405
Practice Address - Country:US
Practice Address - Phone:970-217-7736
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-31
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1-14-15113103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO1-14-15113OtherBEHAVIOR THERAPY