Provider Demographics
NPI:1063853430
Name:REINER, AMBER MARIE (MS, BCBA)
Entity Type:Individual
Prefix:MRS
First Name:AMBER
Middle Name:MARIE
Last Name:REINER
Suffix:
Gender:F
Credentials:MS, BCBA
Other - Prefix:MS
Other - First Name:AMBER
Other - Middle Name:MARIE
Other - Last Name:WILES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, BCBA
Mailing Address - Street 1:1406 CENTAUR CIR
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:CO
Mailing Address - Zip Code:80026-1432
Mailing Address - Country:US
Mailing Address - Phone:720-837-2348
Mailing Address - Fax:303-559-5657
Practice Address - Street 1:1200 W SOUTH BOULDER RD
Practice Address - Street 2:SUITE 203
Practice Address - City:LAFAYETTE
Practice Address - State:CO
Practice Address - Zip Code:80026-3546
Practice Address - Country:US
Practice Address - Phone:720-837-2348
Practice Address - Fax:303-559-5657
Is Sole Proprietor?:No
Enumeration Date:2013-07-12
Last Update Date:2016-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1-13-13932103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst