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General NPI Number Information
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NPI Number | 1184579229
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Entity Type | Organization
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Legal Business Name | TINY TRAILS PEDIATRIC THERAPY, LLC
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Dates
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Enumeration Date | 03/03/2026
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Last Update Date | 03/03/2026
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Provider Practice Location Address
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Address Line | 12822 PENSADOR DR
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City | COLORADO SPRINGS
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State | CO
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Zip | 80921-2049
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Country | US
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Telephone | 719-203-7141
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Fax | 719-960-2630
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Provider Business Mailing Address
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Address Line | 12822 PENSADOR DR
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City | COLORADO SPRINGS
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State | CO
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Zip | 80921-2049
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | BUSINESS OWNER/CEO
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Name | JENNIFER STONE
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Credential | MS/CCC-SLP
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Telephone | 719-203-7141
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number |
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License Number State |
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