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General NPI Number Information
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NPI Number | 1194359943
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Entity Type | Individual
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Provider Name | CARLEE LACER BCBA
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Gender | Female
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Dates
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Enumeration Date | 03/01/2020
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Last Update Date | 12/26/2024
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Provider Practice Location Address
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Address Line | 4016 BOULDER DR
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City | LOVELAND
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State | CO
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Zip | 80538-2004
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Country | US
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Telephone | 303-960-5096
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Fax |
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Provider Business Mailing Address
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Address Line | 4016 BOULDER DR
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City | LOVELAND
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State | CO
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Zip | 80538-2004
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Country | US
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Telephone | 303-960-5096
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number | RBT-18-67781
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 1-24-77888
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License Number State |
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