Provider Demographics
NPI:1225382237
Name:RICHARDSON, BRITTANY MARIE (AUD)
Entity Type:Individual
Prefix:
First Name:BRITTANY
Middle Name:MARIE
Last Name:RICHARDSON
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 1:4900 S MONACO ST
Mailing Address - Street 2:#210
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80237-3486
Mailing Address - Country:US
Mailing Address - Phone:303-301-9019
Mailing Address - Fax:303-861-6254
Practice Address - Street 1:2055 HIGH ST
Practice Address - Street 2:#110
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80205-5503
Practice Address - Country:US
Practice Address - Phone:303-301-9019
Practice Address - Fax:303-861-6254
Is Sole Proprietor?:No
Enumeration Date:2012-10-30
Last Update Date:2014-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO662231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE1225382237Medicaid
KS201073330AMedicaid
CO27377776Medicaid
WY1225382237Medicaid