Provider Demographics
NPI:1205003548
Name:EPPE, OLIVIA (CCC-SLP)
Entity type:Individual
Prefix:
First Name:OLIVIA
Middle Name:
Last Name:EPPE
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 1:4880 W 128TH PL
Mailing Address - Street 2:
Mailing Address - City:BROOMFIELD
Mailing Address - State:CO
Mailing Address - Zip Code:80020-5749
Mailing Address - Country:US
Mailing Address - Phone:303-808-8985
Mailing Address - Fax:
Practice Address - Street 1:4880 W 128TH PL
Practice Address - Street 2:
Practice Address - City:BROOMFIELD
Practice Address - State:CO
Practice Address - Zip Code:80020-5749
Practice Address - Country:US
Practice Address - Phone:303-808-8985
Practice Address - Fax:303-343-3837
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-15
Last Update Date:2015-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO81488203Medicaid