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Individual

BRIAN MANZANARES

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.A. CCC-SLP

Contact information

Practice address
8401 ARISTA PL, BROOMFIELD, CO 80021-4154
(720) 777-9502
Mailing address
8401 ARISTA PL, BROOMFIELD, CO 80021-4154
(720) 777-9502

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP.0001941
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
14036228
AMERICAN SPEECH-LANUGAGE-HEARING ASSOCIATION
CO
01
SLP.0001941
COLORADO DEPARTMENT OF REGULATORY AGENCIES
CO
Enumeration date
01/12/2017
Last updated
01/12/2017
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