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NPI Code Detail

MEDICARE: EMILY JEANETTE STEVENSON

MEDICARE: EMILY JEANETTE STEVENSON
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
1235Z00000XSpeech-Language PathologistAZ

General Provider Information

NPI Number : 1326302845
Entity Type Code : Individual
Provider Name (Legal Business Name) : EMILY JEANETTE STEVENSON
Provider Business Mailing Address
First Line : 120 EDGEVIEW DR APT 4316
Second Line :
City : BROOMFIELD
State : CO
Zip : 80021-8089
Country : US
Telephone Number : 480-202-2710
Fax Number :
Provider Business Practice Location Address
First Line : 4500 E CHERRY CREEK SOUTH DR STE 710
Second Line :
City : DENVER
State : CO
Zip : 80246-1534
Country : US
Telephone Number : 303-432-8487
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/28/2012
Last Update Date : 07/21/2022

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Directions to “ EMILY JEANETTE STEVENSON ” Practice Location

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