Provider Demographics
NPI:1245094515
Name:FIREFLY PEDIATRIC THERAPIES, LLC
Entity type:Organization
Organization Name:FIREFLY PEDIATRIC THERAPIES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:AVANCE
Authorized Official - Suffix:
Authorized Official - Credentials:MS CCC-SLP; IBCLC
Authorized Official - Phone:817-909-3948
Mailing Address - Street 1:9205 IRONWOOD WAY
Mailing Address - Street 2:
Mailing Address - City:HIGHLANDS RANCH
Mailing Address - State:CO
Mailing Address - Zip Code:80129-6431
Mailing Address - Country:US
Mailing Address - Phone:817-909-3948
Mailing Address - Fax:
Practice Address - Street 1:9205 IRONWOOD WAY
Practice Address - Street 2:
Practice Address - City:HIGHLANDS RANCH
Practice Address - State:CO
Practice Address - Zip Code:80129-6431
Practice Address - Country:US
Practice Address - Phone:817-909-3948
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-07
Last Update Date:2024-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
No261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and SpeechGroup - Multi-Specialty
No261QX0100XAmbulatory Health Care FacilitiesClinic/CenterOccupational Medicine