Most Relevant Information
Provider Data
| NPI Number: | 1003284696 |
| Provider Name: | SHANNON NICOLE LAWRENCE COTA |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 09/13/2015 |
| Last Updated: | 04/11/2019 |
Provider Practice Location
7220 W JEFFERSON AVE STE 202
LAKEWOOD
CO
802352023
Practice Location Phone/Fax
| Phone: | 3032257673 |
| Fax: |
Provider Mailing Location
915 EMERY ST
LONGMONT
CO
805014508
Provider Mailing Phone/Fax
| Phone: | 7204501750 |
| Fax: |