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General NPI Number Information
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NPI Number | 1790155703
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Entity Type | Organization
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Legal Business Name | MINDY TEIKEN, MA CCC-SLP, LLC
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Dates
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Enumeration Date | 10/02/2015
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Last Update Date | 10/02/2015
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Provider Practice Location Address
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Address Line | 2432 S DOWNING ST
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City | DENVER
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State | CO
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Zip | 80210-5812
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Country | US
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Telephone | 303-916-1033
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Fax |
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Provider Business Mailing Address
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Address Line | 1390 S WASHINGTON ST
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City | DENVER
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State | CO
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Zip | 80210-2241
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Country | US
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Telephone | 303-916-1033
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Fax |
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Authorized Official
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Title or Position | SPEECH PATHOLOGIST
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Name | MELINDA TEIKEN
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Credential | MA CCC-SLP
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Telephone | 303-916-1033
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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 | SLP.0001147
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License Number State | CO
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