Provider Demographics
NPI:1366900029
Name:DENSLOW, COLLEEN (BCBA)
Entity type:Individual
Prefix:
First Name:COLLEEN
Middle Name:
Last Name:DENSLOW
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:COLLEEN
Other - Middle Name:
Other - Last Name:CASSIDY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BCBA
Mailing Address - Street 1:45 W HAVEN RD
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03104-2827
Mailing Address - Country:US
Mailing Address - Phone:603-486-6788
Mailing Address - Fax:
Practice Address - Street 1:45 W HAVEN RD
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03104-2827
Practice Address - Country:US
Practice Address - Phone:603-486-6788
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-12
Last Update Date:2025-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH1-11-8057103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst