Provider Demographics
NPI:1053805853
Name:MARCHITELLO, ALEC JOHN (RBT)
Entity type:Individual
Prefix:
First Name:ALEC
Middle Name:JOHN
Last Name:MARCHITELLO
Suffix:
Gender:M
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1075 TABLE TOP TER
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80904-2264
Mailing Address - Country:US
Mailing Address - Phone:720-217-9228
Mailing Address - Fax:
Practice Address - Street 1:5540 N ACADEMY BLVD STE 160
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80918-3665
Practice Address - Country:US
Practice Address - Phone:720-358-4634
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-15
Last Update Date:2018-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician