Provider Demographics
NPI:1194318006
Name:GUERRERO, MAYRA LILIANA (DSP,QMAP)
Entity type:Individual
Prefix:MISS
First Name:MAYRA
Middle Name:LILIANA
Last Name:GUERRERO
Suffix:
Gender:F
Credentials:DSP,QMAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:901 FULTON ST
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80010-3917
Mailing Address - Country:US
Mailing Address - Phone:720-878-1353
Mailing Address - Fax:
Practice Address - Street 1:901 FULTON ST
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80010-3917
Practice Address - Country:US
Practice Address - Phone:720-878-1353
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-11
Last Update Date:2021-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician