MEDICARE: LUCY WITZIG SPEECH PATHOLOGIST

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	13355	FL
2	235Z00000X	Speech-Language Pathologist	SLP.0005820	CO

General Provider Information

NPI Number	:	1912482274
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LUCY WITZIG SPEECH PATHOLOGIST

Provider Business Mailing Address
First Line	:	13376 CEDARVILLE WAY
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80921-7642
Country	:	US
Telephone Number	:	251-554-5338
Fax Number	:

Provider Business Practice Location Address
First Line	:	4565 HILTON PKWY STE 101
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80907-3540
Country	:	US
Telephone Number	:	303-284-4021
Fax Number	:

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

Provider Enumeration Date	:	10/02/2018
Last Update Date	:	07/01/2024

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Directions to “ LUCY WITZIG SPEECH PATHOLOGIST” Practice Location

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