Provider Demographics
NPI:1063267078
Name:BABICIUTE ROJAS, ONA (MCC STUDENT)
Entity type:Individual
Prefix:
First Name:ONA
Middle Name:
Last Name:BABICIUTE ROJAS
Suffix:
Gender:F
Credentials:MCC STUDENT
Other - Prefix:
Other - First Name:ONA
Other - Middle Name:
Other - Last Name:BABICIUTE ROJAS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MCC STUDENT
Mailing Address - Street 1:4856 INNOVATION DR
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80525-5539
Mailing Address - Country:US
Mailing Address - Phone:970-494-4200
Mailing Address - Fax:844-270-1824
Practice Address - Street 1:151 W LAKE ST STE 1500
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80524-4124
Practice Address - Country:US
Practice Address - Phone:970-297-7600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-22
Last Update Date:2025-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO390200000X
172A00000X, 106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No172A00000XOther Service ProvidersDriver
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician