Healthcare Provider Details

I. General information

NPI: 1144736604
Provider Name (Legal Business Name): ZAIRA LOPEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/20/2017
Last Update Date: 04/15/2026
Certification Date: 04/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1330 QUAIL LAKE LOOP STE 200
COLORADO SPRINGS CO
80906-4651
US

IV. Provider business mailing address

1330 QUAIL LAKE LOOP STE 200
COLORADO SPRINGS CO
80906-4651
US

V. Phone/Fax

Practice location:
  • Phone: 719-540-2152
  • Fax:
Mailing address:
  • Phone: 719-540-2152
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number14962
License Number State
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-26-89151
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: