Provider Demographics
NPI:1447408661
Name:RADER, THERESA SCARLOTTA (AUD)
Entity Type:Individual
Prefix:DR
First Name:THERESA
Middle Name:SCARLOTTA
Last Name:RADER
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 1:6982 SECREST CT
Mailing Address - Street 2:
Mailing Address - City:ARVADA
Mailing Address - State:CO
Mailing Address - Zip Code:80007-7650
Mailing Address - Country:US
Mailing Address - Phone:720-985-2972
Mailing Address - Fax:
Practice Address - Street 1:1660 S ALBION ST
Practice Address - Street 2:#425
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80222-4008
Practice Address - Country:US
Practice Address - Phone:720-214-2549
Practice Address - Fax:303-744-7876
Is Sole Proprietor?:No
Enumeration Date:2008-08-29
Last Update Date:2014-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO538231H00000X
CAAU 2999231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist