Provider Demographics
NPI:1518748540
Name:LOMONACO, TAYLOR ALEXA
Entity Type:Individual
Prefix:
First Name:TAYLOR
Middle Name:ALEXA
Last Name:LOMONACO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2555 17TH ST APT 314
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80211-6460
Mailing Address - Country:US
Mailing Address - Phone:516-587-9951
Mailing Address - Fax:
Practice Address - Street 1:2776 JANITELL RD
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80906-4103
Practice Address - Country:US
Practice Address - Phone:719-332-4689
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-05
Last Update Date:2023-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist