Provider Demographics
NPI:1720013154
Name:SNELLING, THERESA MARIE (MA,CCC-SLP)
Entity Type:Individual
Prefix:
First Name:THERESA
Middle Name:MARIE
Last Name:SNELLING
Suffix:
Gender:F
Credentials:MA,CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9255 W ALAMEDA AVE
Mailing Address - Street 2:UNIT C
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80226-2802
Mailing Address - Country:US
Mailing Address - Phone:303-232-5711
Mailing Address - Fax:303-232-5711
Practice Address - Street 1:9255 W ALAMEDA AVE
Practice Address - Street 2:UNIT C
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80226-2802
Practice Address - Country:US
Practice Address - Phone:303-232-5711
Practice Address - Fax:303-232-5711
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO07620636Medicaid