Provider Demographics
NPI:1750809943
Name:SHAPIRO, DEBRA JOY (LIC AC)
Entity type:Individual
Prefix:
First Name:DEBRA
Middle Name:JOY
Last Name:SHAPIRO
Suffix:
Gender:F
Credentials:LIC AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6565 W JEWELL AVE STE 5
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80232-7102
Mailing Address - Country:US
Mailing Address - Phone:303-250-3044
Mailing Address - Fax:
Practice Address - Street 1:6565 W JEWELL AVE STE 5
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80232-7102
Practice Address - Country:US
Practice Address - Phone:303-250-3044
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-07
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO201171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist