Individual ProviderDiane HerdegenBehavior TechnicianBehavioral Health & Social Service ProvidersPractice Address1930 Frequent Flyer Pt, Colorado Springs, CO 80915-1500(800) 345-0448PECOS EnrollmentBased on the most recent information from CMS, provider Diane Herdegen does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1679109136Provider TypeIndividualFull NameHerdegen, DianeGenderFemaleSole ProprietorYesEnumeration Date3/17/2020Last Updated3/17/2020Contact InformationPractice LocationPractice Address1930 Frequent Flyer Pt, Colorado Springs, CO 80915-1500Phone(800) 345-0448FaxUnlisted FaxMailing LocationMailing Address1930 Frequent Flyer Pt, Colorado Springs, CO 80915-1500Phone(800) 345-0448FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode106S00000XPrimaryDescriptionBehavior TechnicianBehavioral Health & Social Service ProvidersLicenseUnlisted Issuer