MEDICARE: BECKY SPENCE M.S. CCC-SLP

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	0467	CO

General Provider Information

NPI Number	:	1235438300
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BECKY SPENCE M.S. CCC-SLP

Provider Business Mailing Address
First Line	:	2290 E PROSPECT RD STE 4
Second Line	:
City	:	FORT COLLINS
State	:	CO
Zip	:	80525-9768
Country	:	US
Telephone Number	:	970-631-3973
Fax Number	:	970-305-4730

Provider Business Practice Location Address
First Line	:	2290 E PROSPECT RD STE 4
Second Line	:
City	:	FORT COLLINS
State	:	CO
Zip	:	80525-9768
Country	:	US
Telephone Number	:	970-631-3973
Fax Number	:	970-305-4730

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

Provider Enumeration Date	:	03/15/2011
Last Update Date	:	06/25/2020

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Directions to “ BECKY SPENCE M.S. CCC-SLP” Practice Location

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