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NPI Code Detail

MEDICARE: MARYANN SODERQUIST SLP

MEDICARE: MARYANN SODERQUIST 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
1235Z00000XSpeech-Language Pathologist12013079CO

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1801966064
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARYANN SODERQUIST SLP
Provider Business Mailing Address
First Line : 3464 S WILLOW ST
Second Line : SUITE 511
City : DENVER
State : CO
Zip : 80231-4531
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 6595 S DAYTON ST
Second Line : SUITE 1500
City : GREENWOOD VILLAGE
State : CO
Zip : 80111-6128
Country : US
Telephone Number : 303-504-9945
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/08/2006
Last Update Date : 07/08/2007

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Directions to “ MARYANN SODERQUIST SLP” Practice Location

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