Provider Demographics
NPI:1366688830
Name:FRONT RANGE SPEECH THERAPY
Entity Type:Organization
Organization Name:FRONT RANGE SPEECH THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH-LANGUAGE PATHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:ABBEY
Authorized Official - Middle Name:BAILEY
Authorized Official - Last Name:COOPER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-770-3300
Mailing Address - Street 1:7901 E BELLEVIEW AVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:ENGLEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80111-6010
Mailing Address - Country:US
Mailing Address - Phone:303-770-3300
Mailing Address - Fax:303-804-0500
Practice Address - Street 1:7901 E BELLEVIEW AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80111-6010
Practice Address - Country:US
Practice Address - Phone:303-770-3300
Practice Address - Fax:303-804-0500
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-05
Last Update Date:2009-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
12073220235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty