Provider Demographics
NPI:1770767048
Name:ABBEY, BRENDA MICHELLE (MS CCC-SLP)
Entity type:Individual
Prefix:
First Name:BRENDA
Middle Name:MICHELLE
Last Name:ABBEY
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5650 S KINGSTON WAY
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80111-3952
Mailing Address - Country:US
Mailing Address - Phone:269-806-6420
Mailing Address - Fax:
Practice Address - Street 1:5650 S KINGSTON WAY
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80111-3952
Practice Address - Country:US
Practice Address - Phone:269-806-6420
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-21
Last Update Date:2023-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZSLP5079235Z00000X
MI7101007890235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist