Provider Demographics
NPI:1417506064
Name:OCAMPO, COLLEEN LYNN (MS CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:COLLEEN
Middle Name:LYNN
Last Name:OCAMPO
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:MS
Other - First Name:COLLEEN
Other - Middle Name:LYNN
Other - Last Name:FLANIGAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS CCC-SLP
Mailing Address - Street 1:19307 E CATALDO AVE
Mailing Address - Street 2:
Mailing Address - City:SPOKANE VALLEY
Mailing Address - State:WA
Mailing Address - Zip Code:99016-9404
Mailing Address - Country:US
Mailing Address - Phone:509-558-5400
Mailing Address - Fax:
Practice Address - Street 1:19307 E CATALDO AVE
Practice Address - Street 2:
Practice Address - City:SPOKANE VALLEY
Practice Address - State:WA
Practice Address - Zip Code:99016-9404
Practice Address - Country:US
Practice Address - Phone:509-558-5400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-06
Last Update Date:2019-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60985545235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist