Provider Demographics
NPI:1609575018
Name:RICHARZ, KYRA (RBT)
Entity Type:Individual
Prefix:
First Name:KYRA
Middle Name:
Last Name:RICHARZ
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 1:13962 E PRINCETON PL STE C
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80014-5106
Mailing Address - Country:US
Mailing Address - Phone:720-490-8688
Mailing Address - Fax:
Practice Address - Street 1:11177 W 8TH AVE STE 220
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80215-5520
Practice Address - Country:US
Practice Address - Phone:720-799-4958
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-24
Last Update Date:2023-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CORBT-23-259951106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician