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Individual

MRS. JOSI AMANDA WAGNER BERMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.S., CCC-SLP

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
235Z00000X
Speech-Language Pathologist
Primary
0000037
CO
235Z00000X
Speech-Language Pathologist
12040893
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0000037
COLORADO LICENSE #
CO
05
03051781
CO
01
12040893
AMERICAN SPEECH LANGUAGE
AL
01
30-0124329
TLC SPEECH THERAPY, INC.
CO
Enumeration date
07/09/2007
Last updated
03/24/2014
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