Provider Demographics
NPI:1477011955
Name:THE COLORADO SPEECH AND LANGUAGE TREATMENT FOUNDATION
Entity Type:Organization
Organization Name:THE COLORADO SPEECH AND LANGUAGE TREATMENT FOUNDATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:
Authorized Official - Last Name:ERICKSON
Authorized Official - Suffix:
Authorized Official - Credentials:EDS, MS CCC-SLP
Authorized Official - Phone:303-668-6848
Mailing Address - Street 1:274 IRON MOUNTAIN DR
Mailing Address - Street 2:
Mailing Address - City:LIVERMORE
Mailing Address - State:CO
Mailing Address - Zip Code:80536-8620
Mailing Address - Country:US
Mailing Address - Phone:303-668-6848
Mailing Address - Fax:
Practice Address - Street 1:274 IRON MOUNTAIN DR
Practice Address - Street 2:
Practice Address - City:LIVERMORE
Practice Address - State:CO
Practice Address - Zip Code:80536-8620
Practice Address - Country:US
Practice Address - Phone:303-668-6848
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-04
Last Update Date:2019-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty