Provider Demographics
NPI:1063031326
Name:ARNESEN, SOPHIA LORENA (LAC)
Entity Type:Individual
Prefix:
First Name:SOPHIA
Middle Name:LORENA
Last Name:ARNESEN
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10129 W 55TH DR UNIT 102
Mailing Address - Street 2:
Mailing Address - City:ARVADA
Mailing Address - State:CO
Mailing Address - Zip Code:80002-4979
Mailing Address - Country:US
Mailing Address - Phone:704-891-7101
Mailing Address - Fax:
Practice Address - Street 1:2150 S BELLAIRE ST STE 206
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80222-4935
Practice Address - Country:US
Practice Address - Phone:303-335-9971
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-15
Last Update Date:2020-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2582171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist