Provider Demographics
NPI:1093485328
Name:ARNOLD, REBECCA AILEEN (AUD)
Entity Type:Individual
Prefix:DR
First Name:REBECCA
Middle Name:AILEEN
Last Name:ARNOLD
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1420 RENAISSANCE DR APT K104
Mailing Address - Street 2:
Mailing Address - City:LONGMONT
Mailing Address - State:CO
Mailing Address - Zip Code:80503-6995
Mailing Address - Country:US
Mailing Address - Phone:630-636-0577
Mailing Address - Fax:
Practice Address - Street 1:9141 GRANT ST STE 240
Practice Address - Street 2:
Practice Address - City:THORNTON
Practice Address - State:CO
Practice Address - Zip Code:80229-4318
Practice Address - Country:US
Practice Address - Phone:303-920-1015
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-17
Last Update Date:2021-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COAUD.0001113231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist