Provider Demographics
NPI:1336346212
Name:BJORNBERG, VIANNE (MS)
Entity Type:Individual
Prefix:
First Name:VIANNE
Middle Name:
Last Name:BJORNBERG
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9035 WADSWORTH PKWY
Mailing Address - Street 2:SUITE 3300
Mailing Address - City:WESTMINSTER
Mailing Address - State:CO
Mailing Address - Zip Code:80021-8634
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9035 WADSWORTH PKWY
Practice Address - Street 2:SUITE 3300
Practice Address - City:WESTMINSTER
Practice Address - State:CO
Practice Address - Zip Code:80021-8634
Practice Address - Country:US
Practice Address - Phone:303-657-3088
Practice Address - Fax:303-657-3200
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CONOT REQUIRED IN CO235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO49800043Medicaid