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General NPI Number Information
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NPI Number | 1346845393
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Entity Type | Organization
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Legal Business Name | PEDIATRIC SPEECH THERAPY ASSOCIATES
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Dates
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Enumeration Date | 11/30/2020
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Last Update Date | 11/30/2020
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Provider Practice Location Address
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Address Line | 9200 W CROSS DR STE 120
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City | LITTLETON
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State | CO
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Zip | 80123-2239
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Country | US
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Telephone | 720-542-8737
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Fax | 720-242-8085
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Provider Business Mailing Address
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Address Line | 9200 W CROSS DR STE 120
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City | LITTLETON
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State | CO
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Zip | 80123-2239
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Country | US
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Telephone | 720-542-8737
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Fax | 720-242-8085
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Authorized Official
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Title or Position | DIRECTOR OF THERAPY
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Name | JESSICA LARKIN SHEPHERD
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Credential |
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Telephone | 720-542-8737
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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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 | 2251P0200X
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Taxonomy Name | Pediatric Physical Therapist
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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 | 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 #4
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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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