Provider Demographics
NPI:1760608459
Name:RIEDO, BECKY (MA CCC SLP)
Entity Type:Individual
Prefix:
First Name:BECKY
Middle Name:
Last Name:RIEDO
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 1:6132 S LIMA WAY
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80111-5814
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4340 E KENTUCKY AVE
Practice Address - Street 2:SUITE 248
Practice Address - City:GLENDALE
Practice Address - State:CO
Practice Address - Zip Code:80246-2060
Practice Address - Country:US
Practice Address - Phone:303-916-2218
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist