Provider Demographics
NPI:1831468172
Name:DODD-BENSEN, YVONNE LISETTE (MA, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:YVONNE
Middle Name:LISETTE
Last Name:DODD-BENSEN
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3015 E HINSDALE AVE
Mailing Address - Street 2:
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80122-1944
Mailing Address - Country:US
Mailing Address - Phone:303-713-9067
Mailing Address - Fax:
Practice Address - Street 1:9900 E ILIFF AVE
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80231-3462
Practice Address - Country:US
Practice Address - Phone:303-636-5932
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-12-15
Last Update Date:2011-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO12011668235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
COPENDINGMedicaid