Provider Demographics
NPI:1215797485
Name:ELDRIDGE, ULRIKA RAE (CCC-SLP)
Entity type:Individual
Prefix:
First Name:ULRIKA
Middle Name:RAE
Last Name:ELDRIDGE
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:ULRIKA
Other - Middle Name:RAE
Other - Last Name:DOEDERLEIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5302 S BROADWAY CIR APT 2-303
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80113-6724
Mailing Address - Country:US
Mailing Address - Phone:720-766-7407
Mailing Address - Fax:
Practice Address - Street 1:656 DILLON WAY
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80011-6803
Practice Address - Country:US
Practice Address - Phone:303-344-0636
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-22
Last Update Date:2024-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPSLP.0001138235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist