Organization
BRIDGES PEDIATRIC SPEECH THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ADRIANNA AVERY MA CCC-SLP (SPEECH LANGUAGE PATHOLOGIST)
(970) 590-9241
Entity
Organization
Contact information
Practice address
1450 BLACK PINE CT, CASTLE ROCK, CO 80104-7610
(970) 590-9241
Mailing address
1450 BLACK PINE CT, CASTLE ROCK, CO 80104-7610
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1326350109
—
CO
Enumeration date
09/08/2019
Last updated
09/08/2019
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