Provider Demographics
NPI:1013776079
Name:THREET, MONIQUE (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:MONIQUE
Middle Name:
Last Name:THREET
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:942 GENEVA ST
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80010-3943
Mailing Address - Country:US
Mailing Address - Phone:720-935-0999
Mailing Address - Fax:
Practice Address - Street 1:3615 M.L.K. JR BLVD.
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80205-4976
Practice Address - Country:US
Practice Address - Phone:303-333-8360
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-13
Last Update Date:2024-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO14149535235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist