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General NPI Number Information
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NPI Number | 1629793989
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Entity Type | Individual
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Provider Name | JILLIAN BELLOFATTO MA, CCC-SLP
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Gender | Female
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Dates
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Enumeration Date | 10/10/2022
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Last Update Date | 10/10/2022
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Provider Practice Location Address
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Address Line | 2440 S WABASH ST
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City | DENVER
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State | CO
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Zip | 80231-3808
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Country | US
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Telephone | 720-405-0500
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Fax |
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Provider Business Mailing Address
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Address Line | 8739 E 29TH PL
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City | DENVER
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State | CO
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Zip | 80238-2828
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Country | US
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Telephone | 908-391-3220
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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 | 14339403
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License Number State | CO
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