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General NPI Number Information
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NPI Number | 1568826550
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Entity Type | Organization
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Legal Business Name | SCHORSCH SPEECH & LANGUAGE
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Dates
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Enumeration Date | 04/06/2016
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Last Update Date | 04/06/2016
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Provider Practice Location Address
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Address Line | 204 MAPLE ST UNIT 406
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City | FORT COLLINS
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State | CO
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Zip | 80521-2080
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Country | US
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Telephone | 970-672-7540
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Fax | 970-692-2273
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Provider Business Mailing Address
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Address Line | 204 MAPLE ST UNIT 406
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City | FORT COLLINS
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State | CO
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Zip | 80521-2080
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Country | US
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Telephone | 970-672-7540
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Fax | 970-692-2273
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Authorized Official
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Title or Position | SPEECH-LANGUAGE PATHOLOGIST
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Name | JEANNE SCHORSCH
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Credential | M.S. CCC
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Telephone | 970-672-7540
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | SLP.00000018
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License Number State | CO
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