Healthcare Provider Details

I. General information

NPI: 1164957940
Provider Name (Legal Business Name): CHRISTINE SEKLECKI M.S., CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/28/2017
Last Update Date: 04/28/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3502 S IVANHOE ST
DENVER CO
80237-1123
US

IV. Provider business mailing address

3502 S IVANHOE ST
DENVER CO
80237-1123
US

V. Phone/Fax

Practice location:
  • Phone: 267-229-5935
  • Fax:
Mailing address:
  • Phone: 267-229-5935
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSLP.0002740
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number2202008242
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: