Individual
LYNETTE MARIE SAN AGUSTIN LIZAMA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3535 PARKMOOR VILLAGE DR, COLORADO SPRINGS, CO 80917-5292
(719) 574-7688
Mailing address
7621 PITCHER PT APT 201, FOUNTAIN, CO 80817-4816
(808) 781-5776
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
05/26/2020
Last updated
05/26/2020
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