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NPI Code Detail

MEDICARE: LISA MARIE FAVAZZA

MEDICARE: LISA MARIE FAVAZZA
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
1235Z00000XSpeech-Language PathologistSLP.0002927CO

General Provider Information

NPI Number : 1720577976
Entity Type Code : Individual
Provider Name (Legal Business Name) : LISA MARIE FAVAZZA
Provider Business Mailing Address
First Line : 551 N PEARL ST APT 608
Second Line :
City : DENVER
State : CO
Zip : 80203-3859
Country : US
Telephone Number : 484-542-6067
Fax Number :
Provider Business Practice Location Address
First Line : 4500 E CHERRY CREEK SOUTH DR STE 710
Second Line :
City : DENVER
State : CO
Zip : 80246-1534
Country : US
Telephone Number : 303-432-8487
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/03/2018
Last Update Date : 05/03/2018

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Directions to “ LISA MARIE FAVAZZA ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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