Healthcare Provider Details

I. General information

NPI: 1831802784
Provider Name (Legal Business Name): LANNA CHRISTINE RUUD M.S, CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/05/2023
Last Update Date: 01/05/2023
Certification Date: 01/05/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22 S ADAMS ST
DENVER CO
80209-2908
US

IV. Provider business mailing address

22 S ADAMS ST
DENVER CO
80209-2908
US

V. Phone/Fax

Practice location:
  • Phone: 303-399-1146
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSLP.0005134
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: