MEDICARE: CELIA WITTROCK

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist		CO

General Provider Information

NPI Number	:	1144083478
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CELIA WITTROCK

Provider Business Mailing Address
First Line	:	4350 S PITKIN ST
Second Line	:
City	:	AURORA
State	:	CO
Zip	:	80015-1974
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4350 S PITKIN ST
Second Line	:
City	:	AURORA
State	:	CO
Zip	:	80015-1974
Country	:	US
Telephone Number	:	720-886-5840
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/31/2024
Last Update Date	:	01/31/2024

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Directions to “ CELIA WITTROCK ” Practice Location

Language	Start Address	Practice Location

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