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NPI Code Detail

MEDICARE: MRS. AMY BALABAN M.ED, CCC-SLP

MEDICARE:  MRS. AMY  BALABAN  M.ED, 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
1235Z00000XSpeech-Language Pathologist0002010CO

General Provider Information

NPI Number : 1871768259
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. AMY BALABAN M.ED, CCC-SLP
Provider Business Mailing Address
First Line : PO BOX 371918
Second Line :
City : DENVER
State : CO
Zip : 80237-5918
Country : US
Telephone Number : 303-550-5254
Fax Number : 720-207-6908
Provider Business Practice Location Address
First Line : 3545 S TAMARAC DR STE 300
Second Line :
City : DENVER
State : CO
Zip : 80237-1432
Country : US
Telephone Number : 303-550-5254
Fax Number : 720-207-6908
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/25/2008
Last Update Date : 08/06/2015

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Directions to “ MRS. AMY BALABAN M.ED, CCC-SLP” Practice Location

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