Provider Demographics
NPI:1841727062
Name:SANDERS, GRACE MOGAN (CCC-SLP)
Entity type:Individual
Prefix:
First Name:GRACE
Middle Name:MOGAN
Last Name:SANDERS
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5300 E CHERRY CREEK SOUTH DR APT 524
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80246-2736
Mailing Address - Country:US
Mailing Address - Phone:970-631-7281
Mailing Address - Fax:
Practice Address - Street 1:4500 E CHERRY CREEK SOUTH DR # 524
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CO
Practice Address - Zip Code:80246-1518
Practice Address - Country:US
Practice Address - Phone:303-432-8487
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-18
Last Update Date:2024-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist