MEDICARE: ASPEN SPEECH THERAPY AND REHABILITATION LLC

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

General Provider Information

NPI Number	:	1942595376
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ASPEN SPEECH THERAPY AND REHABILITATION LLC

Provider Business Mailing Address
First Line	:	1136 E STUART ST STE 3120
Second Line	:
City	:	FORT COLLINS
State	:	CO
Zip	:	80525-1196
Country	:	US
Telephone Number	:	970-682-3743
Fax Number	:

Provider Business Practice Location Address
First Line	:	1136 E STUART ST STE 3120
Second Line	:
City	:	FORT COLLINS
State	:	CO
Zip	:	80525-1196
Country	:	US
Telephone Number	:	970-682-3743
Fax Number	:

Authorized Official
Title or Position	:	SPEECH PATHOLOGIST
Name	:	KRISTI LEIGH KELLY
Credential	:	M.S., CCC/SLP
Telephone Number	:	970-682-3743

Provider Enumeration Date	:	06/14/2011
Last Update Date	:	08/21/2019

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Directions to “ASPEN SPEECH THERAPY AND REHABILITATION LLC ” Practice Location

Language	Start Address	Practice Location

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