Provider Demographics
NPI:1275196487
Name:GURUNG, RIYA (MSCCC-SLP)
Entity Type:Individual
Prefix:
First Name:RIYA
Middle Name:
Last Name:GURUNG
Suffix:
Gender:F
Credentials:MSCCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16021 E BOLLING DR
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80239-5542
Mailing Address - Country:US
Mailing Address - Phone:857-919-5746
Mailing Address - Fax:
Practice Address - Street 1:16021 E BOLLING DR
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80239-5542
Practice Address - Country:US
Practice Address - Phone:857-919-5746
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-15
Last Update Date:2019-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0003321261QH0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech