Individual
KELLY JULIET ASCANIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1321 S PRAIRIE AVE, PUEBLO, CO 81005-2307
(719) 597-0822
Mailing address
1321 S PRAIRE AVE, PUEBLO, CO 81005
(719) 569-4411
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP0005732
CO
Other
Enumeration date
12/22/2023
Last updated
01/10/2024
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