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General NPI Number Information
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NPI Number | 1427407675
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Entity Type | Individual
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Provider Name | TIYA GALLEGOS MS CCC-SLP
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Gender | Female
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Dates
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Enumeration Date | 06/08/2016
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Last Update Date | 04/09/2021
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Provider Practice Location Address
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Address Line | 9100 E FLORIDA AVE APT 6308
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City | DENVER
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State | CO
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Zip | 80247-2854
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Country | US
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Telephone | 714-294-8156
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Fax |
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Provider Business Mailing Address
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Address Line | 7842 ZUNI ST
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City | DENVER
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State | CO
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Zip | 80221-4252
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Country | US
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Telephone | 714-294-8156
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 0002130
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 22203
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License Number State | CA
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