Organization Name: | SHINE SPEECH LANGUAGE PATHOLOGY LLC |
NPI Number: | 1073998324 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | CHARLENE CHRISTIANSON (OWNER) |
Mailing Address: | 209 Nelson St Erie |
State: | CO US |
Postal Code: | 805162516 |
Phone Number: | 3035964113 |
Fax Number: | |
NPI Enumeration Date: | 07/28/2015 |
NPI Last Update Date: | 07/28/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 0000368 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CO |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Speech-Language Pathologist |
Taxonomy Specialization: | |
Taxonomy Definition: | A speech pathologist is a person qualified by a master |