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Organization
TLC SPEECH THERAPY, INC
Active
Organization
TLC SPEECH THERAPY, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSI AMANDA WAGNER BERMANK M.S., CCC-SLP (OWNER/SPEECH PATHOLOGIST)
(303) 883-2293
Entity
Organization
Contact information
Practice address
626 GOLDEN EAGLE CIR, GOLDEN, CO 80401-0909
(303) 883-2293
(866) 543-7981
Mailing address
626 GOLDEN EAGLE CIR, GOLDEN, CO 80401-0909
(303) 883-2293
(866) 543-7981
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
0000037
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000037
COLORADO LICENSE #
CO
05
—
03051781
—
CO
01
—
12040893
AMERICAN SPEECH AND HEARING ASSOCIATION
CO
Enumeration date
03/24/2014
Last updated
03/24/2014
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