Provider Demographics
NPI:1447784954
Name:SHIMEK, RICHELLE (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:RICHELLE
Middle Name:
Last Name:SHIMEK
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2870 MAGNOLIA ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80207-3508
Mailing Address - Country:US
Mailing Address - Phone:612-860-3564
Mailing Address - Fax:
Practice Address - Street 1:3105 W. ARKANSAS AVE
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80219
Practice Address - Country:US
Practice Address - Phone:303-936-9981
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-12
Last Update Date:2017-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO14081336235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist