Provider Demographics
NPI:1043418361
Name:PIOTROWSKI, RITA LINDA (MA, SLP)
Entity Type:Individual
Prefix:MS
First Name:RITA
Middle Name:LINDA
Last Name:PIOTROWSKI
Suffix:
Gender:F
Credentials:MA, SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1330 LONE SCOUT LOOKOUT
Mailing Address - Street 2:
Mailing Address - City:MONUMENT
Mailing Address - State:CO
Mailing Address - Zip Code:80132-3400
Mailing Address - Country:US
Mailing Address - Phone:719-481-8778
Mailing Address - Fax:
Practice Address - Street 1:1330 LONE SCOUT LOOKOUT
Practice Address - Street 2:
Practice Address - City:MONUMENT
Practice Address - State:CO
Practice Address - Zip Code:80132-3400
Practice Address - Country:US
Practice Address - Phone:719-481-8778
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0278035235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO51273543Medicaid