Provider Demographics
NPI:1912289448
Name:ENOS, HEATHER A (BCBA, EDS)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:A
Last Name:ENOS
Suffix:
Gender:F
Credentials:BCBA, EDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1118 N ARCADIA ST
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80903-2639
Mailing Address - Country:US
Mailing Address - Phone:720-384-5312
Mailing Address - Fax:
Practice Address - Street 1:1118 N ARCADIA ST
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80903-2639
Practice Address - Country:US
Practice Address - Phone:720-384-5312
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-10
Last Update Date:2011-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1-11-8937103K00000X
CO103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool