Provider Demographics
NPI:1821382722
Name:SUTHERLAND, CARLIE L (MS CCC SLP)
Entity Type:Individual
Prefix:
First Name:CARLIE
Middle Name:L
Last Name:SUTHERLAND
Suffix:
Gender:F
Credentials:MS CCC SLP
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Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1885 CHERRYVILLE RD
Mailing Address - Street 2:AAC SPECIALISTS LLC
Mailing Address - City:GREENWOOD VILLAGE
Mailing Address - State:CO
Mailing Address - Zip Code:80121-1504
Mailing Address - Country:US
Mailing Address - Phone:303-204-5188
Mailing Address - Fax:303-761-9491
Practice Address - Street 1:1885 CHERRYVILLE RD
Practice Address - Street 2:AAC SPECIALISTS LLC
Practice Address - City:GREENWOOD VILLAGE
Practice Address - State:CO
Practice Address - Zip Code:80121-1504
Practice Address - Country:US
Practice Address - Phone:303-204-5188
Practice Address - Fax:303-761-9491
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-08
Last Update Date:2014-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO12145496235Z00000X
12145496235Z00000X
COSLP0000137235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist