Provider Demographics
NPI:1285382374
Name:EXPERT SPEECH & SWALLOW THERAPY, LLC
Entity type:Organization
Organization Name:EXPERT SPEECH & SWALLOW THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH PATHOLOGIST/ OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DIANE
Authorized Official - Middle Name:
Authorized Official - Last Name:ROBERTS
Authorized Official - Suffix:
Authorized Official - Credentials:MA, CCC-SLP
Authorized Official - Phone:720-545-2045
Mailing Address - Street 1:9101 E KENYON AVE STE 2600
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80237-1898
Mailing Address - Country:US
Mailing Address - Phone:720-545-2045
Mailing Address - Fax:303-955-6660
Practice Address - Street 1:9101 E KENYON AVE STE 2600
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80237-1898
Practice Address - Country:US
Practice Address - Phone:720-545-2045
Practice Address - Fax:303-955-6660
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-17
Last Update Date:2023-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO1275824005Medicaid