Doctor Name: | REBECCA ELDRIDGE |
NPI Number: | 1649627340 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | CCC-SLP |
License Number: | 14056401 |
Business Practice Address: | 4485 Comanche Dr Apt 2 Boulder, CO - 803033683 |
Business Phone Number: | 9162207947 |
Business Fax Number: | |
Mailing Address: | 4485 Comanche Dr Apt 2, BOULDER |
State: | CO |
Postal Code: | 803033683 |
Phone Number: | 9162207947 |
Fax Number: | |
NPI Enumeration Date: | 05/23/2016 |
NPI Last Update Date: | 05/23/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 14056401 |
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 |