Individual
CALLISSA M LUCERO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BACHELORS
Contact information
Practice address
11698 HURON ST BLDG 5, NORTHGLENN, CO 80234-2920
(720) 381-0264
Mailing address
5420 E 67TH AVE, COMMERCE CITY, CO 80022-2434
(720) 903-5744
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
170687490
CO
Other
Enumeration date
12/09/2024
Last updated
12/09/2024
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