Provider Demographics
NPI:1790356657
Name:BARATTA, MEGAN MARIE (MS, CCC-SLP)
Entity Type:Individual
Prefix:MISS
First Name:MEGAN
Middle Name:MARIE
Last Name:BARATTA
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 1:2122 TESLA DR
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80909-1449
Mailing Address - Country:US
Mailing Address - Phone:630-525-1083
Mailing Address - Fax:
Practice Address - Street 1:2122 TESLA DR
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80909-1449
Practice Address - Country:US
Practice Address - Phone:630-525-1083
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-01
Last Update Date:2023-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPSLP.0000771235Z00000X
CO14453963235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist