Healthcare Provider Details

I. General information

NPI: 1710844980
Provider Name (Legal Business Name): ROSE VAN CAMP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/08/2026
Last Update Date: 01/08/2026
Certification Date: 01/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13342 BIRCH CIR
THORNTON CO
80241-1522
US

IV. Provider business mailing address

13342 BIRCH CIR
THORNTON CO
80241-1522
US

V. Phone/Fax

Practice location:
  • Phone: 720-666-2476
  • Fax: 720-666-2476
Mailing address:
  • Phone: 720-666-2476
  • Fax: 720-666-2476

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberPSLP.00001259
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: