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General NPI Number Information
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NPI Number | 1093188120
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Entity Type | Organization
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Legal Business Name | ALLISON SHERRY SPEECH THERAPY
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Dates
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Enumeration Date | 11/11/2015
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Last Update Date | 11/11/2015
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Provider Practice Location Address
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Address Line | 8120 WILLOW BEND CT
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City | BOULDER
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State | CO
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Zip | 80301-5017
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Country | US
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Telephone | 720-470-0237
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Fax |
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Provider Business Mailing Address
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Address Line | 8120 WILLOW BEND CT
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City | BOULDER
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State | CO
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Zip | 80301-5017
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Country | US
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Telephone | 720-470-0237
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Fax |
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Authorized Official
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Title or Position | CEO/SPEECH-LANGUAGE PATHOLOGIST
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Name | ALLISON SHERRY
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Credential | MS, CCC-SLP
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Telephone | 720-470-0237
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 273Y00000X
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Taxonomy Name | Rehabilitation Hospital Unit
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License Number | SLP.0002179
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License Number State | CO
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