Individual
ALEXANDRIA PORTILLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, SLP-CCC
Contact information
Practice address
17230 JACKSON CREEK PKWY STE 220, MONUMENT, CO 80132-7304
(719) 488-3348
Mailing address
1901 MANITOBA DR, COLORADO SPRINGS, CO 80910-3322
(505) 660-3457
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
14229709
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14229709
AMERICAN SPEECH AND HEARING ASSOCIATION
—
Enumeration date
04/02/2019
Last updated
02/12/2024
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