Provider Demographics
NPI:1962428151
Name:ARRIOLA-STORY, LUCIA (AUD)
Entity type:Individual
Prefix:
First Name:LUCIA
Middle Name:
Last Name:ARRIOLA-STORY
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:892 COTTONWOOD ST
Mailing Address - Street 2:SUITE #2
Mailing Address - City:CORTEZ
Mailing Address - State:CO
Mailing Address - Zip Code:81321-2200
Mailing Address - Country:US
Mailing Address - Phone:970-565-4655
Mailing Address - Fax:970-565-4531
Practice Address - Street 1:892 COTTONWOOD ST
Practice Address - Street 2:SUITE #2
Practice Address - City:CORTEZ
Practice Address - State:CO
Practice Address - Zip Code:81321-2200
Practice Address - Country:US
Practice Address - Phone:970-565-4655
Practice Address - Fax:970-565-4531
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-14
Last Update Date:2022-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO343231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO46604839Medicaid
COP67740Medicare UPIN
COC544558Medicare PIN