Healthcare Provider Details

I. General information

NPI: 1952243081
Provider Name (Legal Business Name): TATIANA ARIELLE REYES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: EDEN EGAN

II. Dates (important events)

Enumeration Date: 04/07/2026
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8000 S LINCOLN ST STE 10
LITTLETON CO
80122-2725
US

IV. Provider business mailing address

865 S QUEBEC ST APT 303A
DENVER CO
80247-6104
US

V. Phone/Fax

Practice location:
  • Phone: 720-319-7614
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: