Provider Demographics
NPI:1811261167
Name:GLUECK, ADAM F (MA CCC-SLP)
Entity type:Individual
Prefix:MR
First Name:ADAM
Middle Name:F
Last Name:GLUECK
Suffix:
Gender:M
Credentials:MA CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7204 SUNSET RIDGE CT
Mailing Address - Street 2:
Mailing Address - City:GLENWOOD SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:81601-2519
Mailing Address - Country:US
Mailing Address - Phone:573-382-3587
Mailing Address - Fax:
Practice Address - Street 1:2305 BLAKE AVE
Practice Address - Street 2:
Practice Address - City:GLENWOOD SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:81601-4325
Practice Address - Country:US
Practice Address - Phone:970-945-5476
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-03-05
Last Update Date:2012-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0001397235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist