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General NPI Number Information
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NPI Number | 1699603225
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Entity Type | Organization
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Legal Business Name | GRAND ADVENTURES THERAPY SERVICES LLC
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Dates
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Enumeration Date | 05/13/2026
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Last Update Date | 05/13/2026
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Provider Practice Location Address
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Address Line | 2813 SECCOMB ST
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City | FORT COLLINS
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State | CO
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Zip | 80526-6211
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Country | US
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Telephone | 970-239-1316
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Fax |
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Provider Business Mailing Address
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Address Line | 4333 CORBETT DR # 1039
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City | FORT COLLINS
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State | CO
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Zip | 80525-6111
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Country | US
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Telephone | 970-239-1316
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | KRISTINE AMY ELMORE
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Credential | M.S., SLP
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Telephone | 970-239-1316
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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 |
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License Number State |
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