MEDICARE: JENNIFER SPIELMAN CCC-SLP

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		CO

General Provider Information

NPI Number	:	1083974414
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER SPIELMAN CCC-SLP

Provider Business Mailing Address
First Line	:	3470 S SHERMAN ST
Second Line	:	SUITE 2
City	:	ENGLEWOOD
State	:	CO
Zip	:	80113-2680
Country	:	US
Telephone Number	:	303-761-4956
Fax Number	:

Provider Business Practice Location Address
First Line	:	3470 S SHERMAN ST
Second Line	:	SUITE 2
City	:	ENGLEWOOD
State	:	CO
Zip	:	80113-2680
Country	:	US
Telephone Number	:	303-761-4956
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/18/2012
Last Update Date	:	03/06/2014

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