Provider Demographics
NPI:1801365507
Name:FLORES CORDON, STEFFANIE
Entity Type:Individual
Prefix:
First Name:STEFFANIE
Middle Name:
Last Name:FLORES CORDON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4750 29TH ST APT 1110
Mailing Address - Street 2:
Mailing Address - City:GREELEY
Mailing Address - State:CO
Mailing Address - Zip Code:80634-8309
Mailing Address - Country:US
Mailing Address - Phone:323-815-2591
Mailing Address - Fax:
Practice Address - Street 1:1901 56TH AVE
Practice Address - Street 2:
Practice Address - City:GREELEY
Practice Address - State:CO
Practice Address - Zip Code:80634-2980
Practice Address - Country:US
Practice Address - Phone:213-587-3488
Practice Address - Fax:970-702-2998
Is Sole Proprietor?:No
Enumeration Date:2018-11-26
Last Update Date:2018-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPSLP.0000467235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist