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General NPI Number Information
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NPI Number | 1730418781
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Entity Type | Organization
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Legal Business Name | R. NEVILLE SPEECH & LANGUAGE LLC
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Dates
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Enumeration Date | 12/21/2009
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Last Update Date | 12/21/2009
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Provider Practice Location Address
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Address Line | 4746 TENNYSON ST
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City | DENVER
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State | CO
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Zip | 80212-2566
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Country | US
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Telephone | 603-785-4316
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Fax |
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Provider Business Mailing Address
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Address Line | 4746 TENNYSON ST
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City | DENVER
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State | CO
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Zip | 80212-2566
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Country | US
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Telephone | 603-785-4316
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | REBECCA NEVILLE
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Credential |
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Telephone | 603-785-4316
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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 | 12111595
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License Number State | CO
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