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General NPI Number Information
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NPI Number | 1700047693
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Entity Type | Organization
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Legal Business Name | LETS TALK SPEECH THERAPY
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Dates
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Enumeration Date | 06/23/2008
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Last Update Date | 06/23/2008
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Provider Practice Location Address
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Address Line | 411 W NEW YORK AVE
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City | CANON CITY
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State | CO
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Zip | 81212-3628
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Country | US
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Telephone | 719-275-8255
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Fax |
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Provider Business Mailing Address
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Address Line | 411 W NEW YORK AVE
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City | CANON CITY
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State | CO
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Zip | 81212-3628
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | CYNTHIA K BOWEN
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Credential |
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Telephone | 719-275-8255
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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 | 0230044
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License Number State | CO
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