Provider Demographics
NPI:1518004035
Name:FENTON, DEBRA ANNE (MS,CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:DEBRA
Middle Name:ANNE
Last Name:FENTON
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 1:695 S COLORADO BLVD STE 20
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80246-8010
Mailing Address - Country:US
Mailing Address - Phone:303-360-0727
Mailing Address - Fax:303-360-0758
Practice Address - Street 1:695 S COLORADO BLVD STE 20
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80246
Practice Address - Country:US
Practice Address - Phone:303-360-0727
Practice Address - Fax:303-360-0758
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-31
Last Update Date:2018-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO49928058Medicaid