Individual
SUSAN VICKSMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S., CCC-SLP
Contact information
Practice address
19284 COTTONWOOD DR, SUITE 101, PARKER, CO 80138-3882
(720) 777-9068
Mailing address
19284 COTTONWOOD DR, SUITE 101, PARKER, CO 80138-3882
(720) 777-9068
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
59
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
59
COLORADO STATE CERTIFICATION
CO
Enumeration date
01/10/2017
Last updated
01/10/2017
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