Provider Demographics
NPI:1548777485
Name:LIGHTFOOT, RIANNE (RBT)
Entity Type:Individual
Prefix:
First Name:RIANNE
Middle Name:
Last Name:LIGHTFOOT
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:904 1ST ST APT A
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80907-5549
Mailing Address - Country:US
Mailing Address - Phone:719-201-7798
Mailing Address - Fax:
Practice Address - Street 1:102 S TEJON ST STE 1100
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80903-2253
Practice Address - Country:US
Practice Address - Phone:719-201-7798
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-12-31
Last Update Date:2021-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CORBT-17-32596106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician