Individual
LIA MANCUSO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS CCC-SLP
Contact information
Practice address
4740 WILLOW ST APT 304, DENVER, CO 80238-3712
(402) 216-3888
Mailing address
4740 WILLOW ST APT 304, DENVER, CO 80238-3712
(402) 216-3888
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
0004350
CO
Other
Enumeration date
12/20/2017
Last updated
06/09/2021
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