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General NPI Number Information
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NPI Number | 1245094515
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Entity Type | Organization
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Legal Business Name | FIREFLY PEDIATRIC THERAPIES, LLC
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Dates
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Enumeration Date | 02/07/2024
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Last Update Date | 02/07/2024
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Provider Practice Location Address
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Address Line | 9205 IRONWOOD WAY
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City | HIGHLANDS RANCH
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State | CO
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Zip | 80129-6431
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Country | US
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Telephone | 817-909-3948
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Fax |
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Provider Business Mailing Address
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Address Line | 9205 IRONWOOD WAY
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City | HIGHLANDS RANCH
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State | CO
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Zip | 80129-6431
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Country | US
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Telephone | 817-909-3948
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | RANDA AVANCE
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Credential | MS CCC-SLP; IBCLC
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Telephone | 817-909-3948
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0700X
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Taxonomy Name | Hearing and Speech Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QX0100X
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Taxonomy Name | Occupational Medicine Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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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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