Provider Demographics
NPI:1003347006
Name:INTEGRATED SPEECH & BEHAVIOR
Entity Type:Organization
Organization Name:INTEGRATED SPEECH & BEHAVIOR
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:
Authorized Official - Last Name:FETTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-596-9074
Mailing Address - Street 1:9700 E POWERS AVE
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD VILLAGE
Mailing Address - State:CO
Mailing Address - Zip Code:80111-3545
Mailing Address - Country:US
Mailing Address - Phone:303-596-9074
Mailing Address - Fax:
Practice Address - Street 1:9700 E POWERS AVE
Practice Address - Street 2:
Practice Address - City:GREENWOOD VILLAGE
Practice Address - State:CO
Practice Address - Zip Code:80111-3545
Practice Address - Country:US
Practice Address - Phone:303-596-9074
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:INTEGRATED SPEECH & BEHAVIOR
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-03-22
Last Update Date:2017-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty