Provider Demographics
NPI:1821203787
Name:SIMON, MAUREEN B (SLP)
Entity type:Individual
Prefix:
First Name:MAUREEN
Middle Name:B
Last Name:SIMON
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:MS
Other - First Name:MAUREEN
Other - Middle Name:A
Other - Last Name:BRADLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:SLP
Mailing Address - Street 1:2311 S DOWNING ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80210-5809
Mailing Address - Country:US
Mailing Address - Phone:312-339-8759
Mailing Address - Fax:
Practice Address - Street 1:495 UINTA WAY
Practice Address - Street 2:SUITE 140
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80230-7110
Practice Address - Country:US
Practice Address - Phone:303-432-8487
Practice Address - Fax:866-716-7233
Is Sole Proprietor?:No
Enumeration Date:2007-05-14
Last Update Date:2013-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL242000361235Z00000X
COSLP.0001367235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist