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1154022135
PHOENIX SHADE RIVERA
COLORADO SPRINGS, CO
NPI
1154022135
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
106S00000X Behavior Technician
Enumeration Date
2023-03-15
Last Update Date
2023-03-15
Business Address
PHOENIX SHADE RIVERA
1233 LAKE PLAZA DR STE D
COLORADO SPRINGS, CO 80906-3567
Phone number: 719-375-2955
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Mailing Address
PHOENIX SHADE RIVERA
2520 PASEO VERDE
COLORADO SPRINGS, CO 80904-1690
Phone number: 719-237-3213
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