=====================================================
General NPI Number Information
=====================================================
NPI Number | 1629508247
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | CAPABLE CONVERSATIONS, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/15/2017
-----------------------------------------------------
Last Update Date | 06/15/2017
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3451 S ELM STREET
-----------------------------------------------------
City | DENVER
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 80222
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 19134390524
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3451 S ELM ST
-----------------------------------------------------
City | DENVER
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 80222-7314
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 19134390524
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER/SPEECH-LANGUAGE PATHOLOGIST
-----------------------------------------------------
Name | JENNIFER RIAT
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 913-439-0524
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 235Z00000X
-----------------------------------------------------
Taxonomy Name | Speech-Language Pathologist
-----------------------------------------------------
License Number | SLP.0001910
-----------------------------------------------------
License Number State | CO
-----------------------------------------------------