Provider Demographics
NPI:1528512092
Name:TRUDGEON, MARLO (MA SLP CCC)
Entity type:Individual
Prefix:
First Name:MARLO
Middle Name:
Last Name:TRUDGEON
Suffix:
Gender:F
Credentials:MA SLP CCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7392 ARBUTUS CT
Mailing Address - Street 2:
Mailing Address - City:ARVADA
Mailing Address - State:CO
Mailing Address - Zip Code:80005-2822
Mailing Address - Country:US
Mailing Address - Phone:303-917-8577
Mailing Address - Fax:
Practice Address - Street 1:7392 ARBUTUS CT
Practice Address - Street 2:
Practice Address - City:ARVADA
Practice Address - State:CO
Practice Address - Zip Code:80005-2822
Practice Address - Country:US
Practice Address - Phone:303-917-8577
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-12
Last Update Date:2022-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0000649235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist