Individual
MARKIE RYDHOLM MICKEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.A. CCC-SLP
Contact information
Practice address
5699 W 20TH ST, GREELEY, CO 80634-2915
(970) 451-1234
Mailing address
12295 CRABAPPLE ST, BROOMFIELD, CO 80020-7975
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP.0003887
CO
Other
Enumeration date
03/14/2020
Last updated
11/18/2022
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