Individual
MARTHA LOUISE DRAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, CCC-SLP
Contact information
Practice address
704 FORTINO BLVD STE A, PUEBLO, CO 81008-2087
(719) 305-8310
(719) 305-9723
Mailing address
704 FORTINO BLVD STE A, PUEBLO, CO 81008-2087
(719) 305-8310
(719) 305-9723
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
0000012
CO
Other
Enumeration date
09/28/2015
Last updated
09/28/2015
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