Provider Demographics
NPI:1144599937
Name:SZCYPINSKI, LISA (RDH, OM)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:
Last Name:SZCYPINSKI
Suffix:
Gender:F
Credentials:RDH, OM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13030 W. 30TH DRIVE
Mailing Address - Street 2:
Mailing Address - City:GOLDEN
Mailing Address - State:CO
Mailing Address - Zip Code:80401
Mailing Address - Country:US
Mailing Address - Phone:720-560-5172
Mailing Address - Fax:720-545-9884
Practice Address - Street 1:965 S. COLORADO BLVD.
Practice Address - Street 2:SUITE 104
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80246
Practice Address - Country:US
Practice Address - Phone:720-560-5172
Practice Address - Fax:720-545-9884
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-22
Last Update Date:2011-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO902927246Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246Z00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, Other