Buck Jack, LLC

NPI #1942018130 in Fountain, Colorado

Provider Information

NPI Number: 1942018130
Entity Type: Organization
Organization Name: Buck Jack, LLC
Primary Specialty: Behavior Analyst
Enumeration Date: Dec 20, 2024
Last Updated: Dec 20, 2024

Practice Location

Address: 901 N SANTA FE AVE
City: Fountain
State: Colorado
ZIP Code: 80817-1738
Phone: (719) 597-0822

Authorized Official

Name: TANNER HALL
Title: CREDENTIALING SPECIALIST
Phone: (719) 597-0822

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Occupational Therapist	225X00000X
Behavior Technician	106S00000X
Occupational Therapy Assistant	224Z00000X
Physical Therapist	225100000X
Physical Therapy Assistant	225200000X
Specialist/Technologist - Speech-Language Assistant — Speech-Language Assistant	2355S0801X
Speech-Language Pathologist	235Z00000X
Behavior Analyst	103K00000X	Primary

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