Individual
LISA ANN ELLISON PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7350 BROADWAY, DENVER, CO 80221-3610
(303) 853-1311
Mailing address
7350 BROADWAY, DENVER, CO 80221-3610
(303) 853-1131
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
359638
CO
Other
Enumeration date
10/10/2023
Last updated
01/27/2024
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