Provider Demographics
NPI:1609093202
Name:BEIGHLEY, NANCY R (MA CCC SLP COM)
Entity Type:Individual
Prefix:MS
First Name:NANCY
Middle Name:R
Last Name:BEIGHLEY
Suffix:
Gender:F
Credentials:MA CCC SLP COM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2885 E AURORA AVE.
Mailing Address - Street 2:SUITE # 1
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80305
Mailing Address - Country:US
Mailing Address - Phone:303-419-9808
Mailing Address - Fax:303-499-9268
Practice Address - Street 1:2885 E AURORA AVENUE
Practice Address - Street 2:SUITE # 1
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80303
Practice Address - Country:US
Practice Address - Phone:303-419-9808
Practice Address - Fax:303-499-9268
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-18
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO19905742Medicaid