Provider Demographics
NPI:1720394752
Name:CORDEIRO, LISA
Entity Type:Individual
Prefix:MRS
First Name:LISA
Middle Name:
Last Name:CORDEIRO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 N. COLORADO BOULEVARD
Mailing Address - Street 2:#334
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80206
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2000 S DAHLIA ST
Practice Address - Street 2:#300
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80222-4758
Practice Address - Country:US
Practice Address - Phone:303-333-8360
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-27
Last Update Date:2010-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst