Provider Demographics
NPI:1639640378
Name:SILVEIRA, RENATA M (LAC)
Entity Type:Individual
Prefix:
First Name:RENATA
Middle Name:M
Last Name:SILVEIRA
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 1:3401 QUEBEC ST STE 6900
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80207-2399
Mailing Address - Country:US
Mailing Address - Phone:720-507-7238
Mailing Address - Fax:
Practice Address - Street 1:3401 QUEBEC ST STE 6900
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80207-2399
Practice Address - Country:US
Practice Address - Phone:720-507-7238
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-06
Last Update Date:2018-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0002342171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist