Individual
OLIVIA GRACE BAUSELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1136 E STUART ST STE 3120, FORT COLLINS, CO 80525-1196
(970) 682-3743
Mailing address
1136 E STUART ST STE 3120, FORT COLLINS, CO 80525-1196
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP.0003641
CO
Other
Enumeration date
07/31/2018
Last updated
08/16/2019
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