MEDICARE: UNLIMITED POTENTIAL THERAPY SERVICES, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist
2	101Y00000X	Counselor

General Provider Information

NPI Number	:	1003082207
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	UNLIMITED POTENTIAL THERAPY SERVICES, LLC

Provider Business Mailing Address
First Line	:	4610 S ULSTER ST
Second Line	:	STE 150
City	:	DENVER
State	:	CO
Zip	:	80237-4321
Country	:	US
Telephone Number	:	303-290-7407
Fax Number	:

Provider Business Practice Location Address
First Line	:	4610 S ULSTER ST
Second Line	:	STE 150
City	:	DENVER
State	:	CO
Zip	:	80237-4321
Country	:	US
Telephone Number	:	303-290-7407
Fax Number	:

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	TIFFANY HENSLEY HINTON
Credential	:
Telephone Number	:	303-290-7407

Provider Enumeration Date	:	05/07/2008
Last Update Date	:	05/07/2008

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Directions to “UNLIMITED POTENTIAL THERAPY SERVICES, LLC ” Practice Location

Language	Start Address	Practice Location

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