Provider Demographics
NPI:1114565488
Name:WEHRLE, MONIQUE CLARE
Entity Type:Individual
Prefix:
First Name:MONIQUE
Middle Name:CLARE
Last Name:WEHRLE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MONIQUE
Other - Middle Name:CLARE
Other - Last Name:BOLLIER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA
Mailing Address - Street 1:349 S KEARNEY ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80224-1235
Mailing Address - Country:US
Mailing Address - Phone:303-875-3050
Mailing Address - Fax:
Practice Address - Street 1:349 S KEARNEY ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80224-1235
Practice Address - Country:US
Practice Address - Phone:303-875-3050
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-17
Last Update Date:2019-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO000235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist