Provider Demographics
NPI:1699047944
Name:VANWINKLE, CALEB JAMES (SLP-A)
Entity type:Individual
Prefix:
First Name:CALEB
Middle Name:JAMES
Last Name:VANWINKLE
Suffix:
Gender:M
Credentials:SLP-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6994 SIERRA MEADOWS DR.
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80908
Mailing Address - Country:US
Mailing Address - Phone:319-750-2668
Mailing Address - Fax:
Practice Address - Street 1:6994 SIERRA MEADOWS DR.
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80908
Practice Address - Country:US
Practice Address - Phone:319-750-2668
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-02-02
Last Update Date:2012-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant