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General NPI Number Information
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NPI Number | 1598488017
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Entity Type | Individual
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Provider Name | HEATHER JEAN LANCSTER-TUCKER
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Gender | Female
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Dates
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Enumeration Date | 09/20/2022
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Last Update Date | 09/20/2022
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Provider Practice Location Address
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Address Line | 7220 W JEFFERSON AVE STE 100
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City | LAKEWOOD
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State | CO
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Zip | 80235-2015
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Country | US
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Telephone | 303-225-7673
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Fax |
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Provider Business Mailing Address
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Address Line | 1911 E 18TH ST APT B
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City | CHEYENNE
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State | WY
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Zip | 82001-5066
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Country | US
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Telephone | 307-640-5636
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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 |
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License Number State |
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