Individual
REBECCA DRAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS,CCC-SLP
Contact information
Practice address
2121 MESA DR, BOULDER, CO 80304-3621
(720) 749-1002
Mailing address
2121 MESA DR, BOULDER, CO 80304-3621
(720) 749-1002
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
.0002034
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14077513
ASHA CERTIFICATION
CO
Enumeration date
11/17/2016
Last updated
11/17/2016
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