Provider Demographics
NPI:1518681089
Name:DAITCH, ROSALYN (MS)
Entity Type:Individual
Prefix:
First Name:ROSALYN
Middle Name:
Last Name:DAITCH
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10579 BRADFORD RD STE 104
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80127-4247
Mailing Address - Country:US
Mailing Address - Phone:303-952-9038
Mailing Address - Fax:720-389-7067
Practice Address - Street 1:10579 BRADFORD RD STE 104
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80127-4247
Practice Address - Country:US
Practice Address - Phone:303-952-9038
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-28
Last Update Date:2022-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
COSLP.0004661OtherCOLORADO DEPARTMENT OF REGULATORY AGENCIES
14090858OtherAMERICAN SPEECH HEARING ASSOCIATION CERTIFICATE OF CLINICAL COMPETENCE