Provider Demographics
NPI:1184077430
Name:NIED, ALICIA
Entity type:Individual
Prefix:
First Name:ALICIA
Middle Name:
Last Name:NIED
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 1:2801 E 120TH AVE
Mailing Address - Street 2:#G-203
Mailing Address - City:THORNTON
Mailing Address - State:CO
Mailing Address - Zip Code:80233-1499
Mailing Address - Country:US
Mailing Address - Phone:608-695-8443
Mailing Address - Fax:
Practice Address - Street 1:495 UINTA WAY
Practice Address - Street 2:SUITE 140
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80230-7110
Practice Address - Country:US
Practice Address - Phone:303-432-8487
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-21
Last Update Date:2016-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPSLP.0000130235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist