Healthcare Provider Details

I. General information

NPI: 1669238937
Provider Name (Legal Business Name): TERESA MARIE GILLESPIE M.S., C.C.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/26/2024
Last Update Date: 02/26/2024
Certification Date: 02/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1860 LINCOLN STREET
DENVER CO
80203
US

IV. Provider business mailing address

1897 S JASMINE ST
DENVER CO
80224-2128
US

V. Phone/Fax

Practice location:
  • Phone: 720-423-2098
  • Fax:
Mailing address:
  • Phone: 303-947-6636
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSLP.0003319
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: