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General NPI Number Information
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NPI Number | 1225303050
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Entity Type | Organization
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Legal Business Name | COMMUNICATION & COGNITIVE THERAPY RESOURCES, LLC
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Dates
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Enumeration Date | 03/12/2012
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Last Update Date | 03/12/2012
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Provider Practice Location Address
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Address Line | 2139 S CUSTER AVE
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City | LOVELAND
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State | CO
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Zip | 80537-7109
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Country | US
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Telephone | 970-232-4274
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Fax |
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Provider Business Mailing Address
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Address Line | 2139 S CUSTER AVE
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City | LOVELAND
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State | CO
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Zip | 80537-7109
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Country | US
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Telephone | 970-232-4274
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Fax |
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Authorized Official
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Title or Position | SPEECH-LANGUAGE PATHOLOGIST
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Name | ADAM MICHAEL HEADLEE
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Credential | M.A., CCC-SLP
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Telephone | 970-232-4274
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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 | 12135404
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License Number State | CO
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