Individual
JERRY DANIEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS,CCC-SLP
Contact information
Practice address
2883 S CIRCLE DR, COLORADO SPRINGS, CO 80906-4112
(719) 380-6230
Mailing address
2883 S CIRCLE DR, COLORADO SPRINGS, CO 80906-4112
(719) 380-6230
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
14034815
CO
235Z00000X
Speech-Language Pathologist
Primary
214630
CO
Other
Enumeration date
08/11/2023
Last updated
08/11/2023
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