Provider Demographics
NPI:1922671106
Name:GAY, KOURTNEY (BCBA)
Entity type:Individual
Prefix:
First Name:KOURTNEY
Middle Name:
Last Name:GAY
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6385 CORPORATE DR STE 200-41
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80919-5901
Mailing Address - Country:US
Mailing Address - Phone:719-341-1150
Mailing Address - Fax:
Practice Address - Street 1:6385 CORPORATE DR STE 200-41
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80919-5901
Practice Address - Country:US
Practice Address - Phone:719-341-1150
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-23
Last Update Date:2024-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst