MEDICARE: HALLIE CAROLINE SEMONIN M.S., 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	SLP 0001686	CO

General Provider Information

NPI Number	:	1780817346
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HALLIE CAROLINE SEMONIN M.S., CCC-SLP

Provider Business Mailing Address
First Line	:	2507 HAMPSHIRE RD
Second Line	:
City	:	FORT COLLINS
State	:	CO
Zip	:	80526-5815
Country	:	US
Telephone Number	:	615-653-6050
Fax Number	:

Provider Business Practice Location Address
First Line	:	2507 HAMPSHIRE RD
Second Line	:
City	:	FORT COLLINS
State	:	CO
Zip	:	80526-5815
Country	:	US
Telephone Number	:	615-653-6050
Fax Number	:

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

Provider Enumeration Date	:	08/31/2009
Last Update Date	:	02/18/2014

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