Organization
GATHER AND GROW THERAPY SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BETHANY MANZANARES MS, CCC-SLP (FOUNDER AND DIRECTOR)
(720) 515-4487
Entity
Organization
Contact information
Practice address
1300 PLAZA CT N STE 101, LAFAYETTE, CO 80026-1467
(720) 515-4487
Mailing address
422 E SIMPSON ST, LAFAYETTE, CO 80026-2328
(720) 515-4487
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
—
—
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1417419532
—
CO
Enumeration date
04/05/2019
Last updated
01/05/2024
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