Individual
DANA RISEDORF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7200 E DRY CREEK RD, CENTENNIAL, CO 80112-2537
(866) 300-0822
(303) 600-9933
Mailing address
3833 S NELSON CT, LAKEWOOD, CO 80235-1150
(720) 261-4153
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-18-72182
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
106S00000X
BACB
CO
Enumeration date
02/21/2019
Last updated
02/21/2019
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