Provider Demographics
NPI:1780707513
Name:POLAND, CORY ANN (MA CCC-SLP)
Entity type:Individual
Prefix:MS
First Name:CORY
Middle Name:ANN
Last Name:POLAND
Suffix:
Gender:F
Credentials:MA CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2723 RAVENHILL CIR
Mailing Address - Street 2:
Mailing Address - City:HIGHLANDS RANCH
Mailing Address - State:CO
Mailing Address - Zip Code:80126-4957
Mailing Address - Country:US
Mailing Address - Phone:317-748-1984
Mailing Address - Fax:
Practice Address - Street 1:10590 MOUNTAIN VISTA RDG
Practice Address - Street 2:
Practice Address - City:HIGHLANDS RANCH
Practice Address - State:CO
Practice Address - Zip Code:80126-5587
Practice Address - Country:US
Practice Address - Phone:317-748-1984
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-08
Last Update Date:2023-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN22003598A235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist