Provider Demographics
NPI:1770360885
Name:ORT, LYDIA (MA CCC-SLP)
Entity type:Individual
Prefix:
First Name:LYDIA
Middle Name:
Last Name:ORT
Suffix:
Gender:F
Credentials:MA CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3076 W 34TH AVE
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80211-3206
Mailing Address - Country:US
Mailing Address - Phone:352-470-6698
Mailing Address - Fax:
Practice Address - Street 1:2835 W 32ND AVE
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80211-3299
Practice Address - Country:US
Practice Address - Phone:303-964-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-12
Last Update Date:2023-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist