Provider Demographics
NPI:1144112988
Name:DUQUE, ANDREW (MA, BCBA)
Entity type:Individual
Prefix:
First Name:ANDREW
Middle Name:
Last Name:DUQUE
Suffix:
Gender:M
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 1:512 N INSTITUTE ST
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80903-3142
Mailing Address - Country:US
Mailing Address - Phone:719-323-3349
Mailing Address - Fax:719-623-0220
Practice Address - Street 1:421 S TEJON ST STE 250
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80903-2139
Practice Address - Country:US
Practice Address - Phone:719-323-3349
Practice Address - Fax:719-623-0220
Is Sole Proprietor?:No
Enumeration Date:2025-07-16
Last Update Date:2025-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO12582133103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst