Provider Demographics
NPI:1205660669
Name:ALTITUDE SPEECH AND FEEDING THERAPY LLC
Entity type:Organization
Organization Name:ALTITUDE SPEECH AND FEEDING THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:EMILY
Authorized Official - Middle Name:GUSTASON
Authorized Official - Last Name:MCELYEA
Authorized Official - Suffix:
Authorized Official - Credentials:MS CCC-SLP
Authorized Official - Phone:719-659-8526
Mailing Address - Street 1:6980 COTTON DR
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80923-6388
Mailing Address - Country:US
Mailing Address - Phone:719-659-8526
Mailing Address - Fax:
Practice Address - Street 1:6980 COTTON DR
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80923-6388
Practice Address - Country:US
Practice Address - Phone:719-659-8526
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-28
Last Update Date:2024-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty