Individual
TARA L ROSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, CCC-SLP
Contact information
Practice address
6107 SOARING DR, COLORADO SPRINGS, CO 80918-6120
(719) 659-5856
(719) 219-5691
Mailing address
6107 SOARING DR, COLORADO SPRINGS, CO 80918-6120
(719) 659-5856
(719) 219-5691
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
0289825
CO
235Z00000X
Speech-Language Pathologist
12026158
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12026158
ASHA CERTIFICATION
—
05
—
125463
—
CO
Enumeration date
04/07/2006
Last updated
04/13/2009
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