Provider Demographics
NPI:1780817346
Name:SEMONIN, HALLIE CAROLINE (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:HALLIE
Middle Name:CAROLINE
Last Name:SEMONIN
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:HALLIE
Other - Middle Name:CAROLINE
Other - Last Name:MCCULLOUGH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS CCC-SLP
Mailing Address - Street 1:2507 HAMPSHIRE RD
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80526-5815
Mailing Address - Country:US
Mailing Address - Phone:615-653-6050
Mailing Address - Fax:
Practice Address - Street 1:2507 HAMPSHIRE RD
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80526-5815
Practice Address - Country:US
Practice Address - Phone:615-653-6050
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-31
Last Update Date:2014-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COSLP 0001686235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist