Healthcare Provider Details

I. General information

NPI: 1548438948
Provider Name (Legal Business Name): DEBRA ANNE FENTON
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/19/2008
Last Update Date: 06/18/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

495 UINTA WAY SUITE 120
DENVER CO
80230-7110
US

IV. Provider business mailing address

495 UINTA WAY SUITE 120
DENVER CO
80230-7110
US

V. Phone/Fax

Practice location:
  • Phone: 303-344-4100
  • Fax:
Mailing address:
  • Phone: 303-344-4100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number StateCO

VIII. Authorized Official

Name: MRS. DEBRA ANNE FENTON
Title or Position: OWNER
Credential: M.S., CCC-SLP
Phone: 303-344-4100