Provider Demographics
NPI:1124445929
Name:MINKLER, PEARLLYNNE (SPL)
Entity type:Individual
Prefix:MRS
First Name:PEARLLYNNE
Middle Name:
Last Name:MINKLER
Suffix:
Gender:F
Credentials:SPL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4000 INDEPENDENCE CT
Mailing Address - Street 2:
Mailing Address - City:WHEAT RIDGE
Mailing Address - State:CO
Mailing Address - Zip Code:80033-1214
Mailing Address - Country:US
Mailing Address - Phone:303-801-7011
Mailing Address - Fax:
Practice Address - Street 1:4000 INDEPENDENCE CT
Practice Address - Street 2:
Practice Address - City:WHEAT RIDGE
Practice Address - State:CO
Practice Address - Zip Code:80033-4112
Practice Address - Country:US
Practice Address - Phone:303-801-7011
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-19
Last Update Date:2014-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO50816235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist