Provider Demographics
NPI:1578921789
Name:DARNELL, TEALE (MA, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:TEALE
Middle Name:
Last Name:DARNELL
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:469 S CHERRY ST STE 201
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80246-1222
Mailing Address - Country:US
Mailing Address - Phone:303-360-0727
Mailing Address - Fax:303-360-0758
Practice Address - Street 1:469 S CHERRY ST STE 201
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80246-1222
Practice Address - Country:US
Practice Address - Phone:303-360-0727
Practice Address - Fax:303-360-0758
Is Sole Proprietor?:No
Enumeration Date:2016-02-02
Last Update Date:2016-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO40285235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist