Provider Demographics
NPI:1750462438
Name:GREENE, COLBY RENEE (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:COLBY
Middle Name:RENEE
Last Name:GREENE
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4067 E 130TH WAY
Mailing Address - Street 2:
Mailing Address - City:THORNTON
Mailing Address - State:CO
Mailing Address - Zip Code:80241-2279
Mailing Address - Country:US
Mailing Address - Phone:720-636-6854
Mailing Address - Fax:
Practice Address - Street 1:3305 W 144TH AVE UNIT 200
Practice Address - Street 2:
Practice Address - City:BROOMFIELD
Practice Address - State:CO
Practice Address - Zip Code:80023-9483
Practice Address - Country:US
Practice Address - Phone:303-659-8822
Practice Address - Fax:303-659-7788
Is Sole Proprietor?:No
Enumeration Date:2006-10-18
Last Update Date:2019-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0003369235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist