Individual
RAENISE SAMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA-CCC, SLP
Contact information
Practice address
411 LAKEWOOD CIR, B 119, COLORADO SPRINGS, CO 80910-2617
(719) 332-4689
Mailing address
411 LAKEWOOD CIR, STE A104, COLORADO SPRINGS, CO 80910-2667
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
0001945
CO
Other
Enumeration date
04/02/2015
Last updated
03/17/2016
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