Provider Demographics
NPI:1225689839
Name:GOTO, ANDREW KENZO (MS CCC-SLP)
Entity type:Individual
Prefix:
First Name:ANDREW
Middle Name:KENZO
Last Name:GOTO
Suffix:
Gender:M
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1860 N LINCOLN ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80203-2996
Mailing Address - Country:US
Mailing Address - Phone:207-423-4004
Mailing Address - Fax:
Practice Address - Street 1:3955 N STEELE ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80205-3613
Practice Address - Country:US
Practice Address - Phone:720-424-1080
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-25
Last Update Date:2025-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSZ9312235Z00000X
COSLP.0005488235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist