Provider Demographics
NPI:1801180047
Name:RIPLEY, AMANDA LEONE (MS BCBA)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:LEONE
Last Name:RIPLEY
Suffix:
Gender:F
Credentials:MS BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1601 GREAT WESTERN DR
Mailing Address - Street 2:UNIT H7
Mailing Address - City:LONGMONT
Mailing Address - State:CO
Mailing Address - Zip Code:80501-9780
Mailing Address - Country:US
Mailing Address - Phone:303-746-8250
Mailing Address - Fax:
Practice Address - Street 1:1400 DIXON AVE
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:CO
Practice Address - Zip Code:80026-2790
Practice Address - Country:US
Practice Address - Phone:303-746-8250
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-06
Last Update Date:2011-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1-10-7202103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst