Provider Demographics
NPI:1396239349
Name:FITCHETT, SYDNEY J (CCC-SLP)
Entity type:Individual
Prefix:
First Name:SYDNEY
Middle Name:J
Last Name:FITCHETT
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 1:515 MONROE ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80206-4448
Mailing Address - Country:US
Mailing Address - Phone:303-718-7780
Mailing Address - Fax:
Practice Address - Street 1:7550 ASSISI HTS
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80919-3853
Practice Address - Country:US
Practice Address - Phone:719-598-1336
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-21
Last Update Date:2019-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
235Z00000X
CO14243937235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist