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Individual

BRIAN LARA-RENTERIA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
7220 W JEFFERSON AVE STE 100, LAKEWOOD, CO 80235-2015
(767) 330-3225
Mailing address
908 S QUITMAN ST, DENVER, CO 80219-3225
(303) 915-6005

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
CO

Other

Enumeration date
01/17/2023
Last updated
01/17/2023
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