Provider Demographics
NPI:1669824918
Name:COLORADO COMMUNICATION THERAPY LLC
Entity Type:Organization
Organization Name:COLORADO COMMUNICATION THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:
Authorized Official - Last Name:MILLAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:707-502-7168
Mailing Address - Street 1:1312 N LAFAYETTE ST APT 17
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80218-2384
Mailing Address - Country:US
Mailing Address - Phone:707-502-7168
Mailing Address - Fax:
Practice Address - Street 1:1312 N LAFAYETTE ST APT 17
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80218-2384
Practice Address - Country:US
Practice Address - Phone:707-502-7168
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-11
Last Update Date:2016-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COSLP.0002403235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty