Individual
EMILY IRENE POLISEO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA CCC SLP
Contact information
Practice address
4812 E KENTUCKY AVE, UNIT F, GLENDALE, CO 80246-2201
(720) 318-4615
Mailing address
4812 EAST KENTUCKY AVENUE, UNIT F, GLENDALE, CO 80246
(720) 318-4615
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
12136614
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
96606223
—
CO
Enumeration date
02/26/2008
Last updated
02/26/2008
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