Provider Demographics
NPI:1386044857
Name:BURROUGHS, PEGGY A (CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:PEGGY
Middle Name:A
Last Name:BURROUGHS
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7701 E 1ST PL
Mailing Address - Street 2:SUITE D
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80230-6920
Mailing Address - Country:US
Mailing Address - Phone:303-360-0727
Mailing Address - Fax:
Practice Address - Street 1:7701 E 1ST PL
Practice Address - Street 2:SUITE D
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80230-6920
Practice Address - Country:US
Practice Address - Phone:303-360-0727
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-02
Last Update Date:2014-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146000497235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist