Provider Demographics
NPI:1760859037
Name:PANZER, SADIE (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:SADIE
Middle Name:
Last Name:PANZER
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:540 BLACKHAWK CT
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80919-1143
Mailing Address - Country:US
Mailing Address - Phone:888-701-9216
Mailing Address - Fax:866-569-1087
Practice Address - Street 1:540 BLACKHAWK CT
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80919-1143
Practice Address - Country:US
Practice Address - Phone:888-701-9216
Practice Address - Fax:866-569-1087
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-21
Last Update Date:2015-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COSLP.0002182235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist