Provider Demographics
NPI:1194825968
Name:SHULER-WOODARD, DEE II
Entity Type:Individual
Prefix:
First Name:DEE
Middle Name:
Last Name:SHULER-WOODARD
Suffix:II
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:615 MOUNT EVANS ST
Mailing Address - Street 2:
Mailing Address - City:LONGMONT
Mailing Address - State:CO
Mailing Address - Zip Code:80501-4635
Mailing Address - Country:US
Mailing Address - Phone:303-678-0818
Mailing Address - Fax:303-678-0818
Practice Address - Street 1:615 MOUNT EVANS ST
Practice Address - Street 2:
Practice Address - City:LONGMONT
Practice Address - State:CO
Practice Address - Zip Code:80501-4635
Practice Address - Country:US
Practice Address - Phone:303-678-0818
Practice Address - Fax:303-678-0818
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0165901235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO53255879Medicaid