Individual
ELLEN RAE MOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA CCC SLP
Contact information
Practice address
6767 S BROADWAY, LITTLETON, CO 80122-8002
(303) 731-1962
Mailing address
6767 S BROADWAY, LITTLETON, CO 80122-8002
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
0003430
CO
Other
Enumeration date
12/16/2018
Last updated
12/16/2018
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